Provider Demographics
NPI:1225297344
Name:NORTHWEST PSYCHIATRY PA
Entity Type:Organization
Organization Name:NORTHWEST PSYCHIATRY PA
Other - Org Name:AVINDER WALIA MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ARVINDER
Authorized Official - Middle Name:PAL SINGH
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-342-7979
Mailing Address - Street 1:11673 JOLLYVILLE ROAD
Mailing Address - Street 2:STE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4200
Mailing Address - Country:US
Mailing Address - Phone:512-342-7979
Mailing Address - Fax:512-637-2596
Practice Address - Street 1:11673 JOLLYVILLE ROAD
Practice Address - Street 2:STE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4200
Practice Address - Country:US
Practice Address - Phone:512-342-7979
Practice Address - Fax:512-637-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00603ZMedicare PIN