Provider Demographics
NPI:1235526195
Name:SP PSYCHIATRIC CONSULTING PLLC
Entity Type:Organization
Organization Name:SP PSYCHIATRIC CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:RAAB
Authorized Official - Last Name:PISKLAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-654-9725
Mailing Address - Street 1:4888 LOOP CENTRAL DR
Mailing Address - Street 2:SUITE 510
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2227
Mailing Address - Country:US
Mailing Address - Phone:713-346-1551
Mailing Address - Fax:713-346-1557
Practice Address - Street 1:4888 LOOP CENTRAL DR
Practice Address - Street 2:SUITE 510
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2227
Practice Address - Country:US
Practice Address - Phone:713-346-1551
Practice Address - Fax:713-346-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN22472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty