Provider Demographics
NPI:1790482834
Name:FREUD HEALTH OF TEXAS, PLLC
Entity Type:Organization
Organization Name:FREUD HEALTH OF TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, CMO
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-686-2706
Mailing Address - Street 1:1211 W 22ND ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2110
Mailing Address - Country:US
Mailing Address - Phone:630-912-4241
Mailing Address - Fax:
Practice Address - Street 1:777 INTERNATIONAL PKWY STE 260
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-5303
Practice Address - Country:US
Practice Address - Phone:972-221-7900
Practice Address - Fax:972-221-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty