Provider Demographics
NPI:1710276225
Name:PSYCHIATRIC INPATIENT MANAGEMENT SERVICES, PLLC
Entity Type:Organization
Organization Name:PSYCHIATRIC INPATIENT MANAGEMENT SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-575-8501
Mailing Address - Street 1:7711 LOUIS PASTEUR DR
Mailing Address - Street 2:SUITE 708
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3415
Mailing Address - Country:US
Mailing Address - Phone:210-575-8229
Mailing Address - Fax:210-575-4013
Practice Address - Street 1:8026 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3915
Practice Address - Country:US
Practice Address - Phone:210-575-8229
Practice Address - Fax:210-575-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0053WNOtherBCBS
TXB128017Medicare PIN