Provider Demographics
NPI:1710363064
Name:S & S PSYCHIATRIC SERVICES PA
Entity Type:Organization
Organization Name:S & S PSYCHIATRIC SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:ASAD
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-307-7686
Mailing Address - Street 1:10200 INDEPENDENCE PKWY APT 602
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-8211
Mailing Address - Country:US
Mailing Address - Phone:703-307-7686
Mailing Address - Fax:
Practice Address - Street 1:115 W LAMBERTH RD
Practice Address - Street 2:#A
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-2658
Practice Address - Country:US
Practice Address - Phone:703-307-7686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-09
Last Update Date:2015-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ29432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty