Provider Demographics
NPI:1821409798
Name:WESTERN PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:WESTERN PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENEGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-515-4343
Mailing Address - Street 1:222 SIDNEY BAKER ST S
Mailing Address - Street 2:SUITE 435
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5994
Mailing Address - Country:US
Mailing Address - Phone:830-515-4343
Mailing Address - Fax:830-315-2274
Practice Address - Street 1:222 SIDNEY BAKER ST S
Practice Address - Street 2:SUITE 435
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5994
Practice Address - Country:US
Practice Address - Phone:830-515-4343
Practice Address - Fax:830-315-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN37252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty