Provider Demographics
NPI:1922126317
Name:PARTNERS IN PSYCHOTHERAPY, PA
Entity Type:Organization
Organization Name:PARTNERS IN PSYCHOTHERAPY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PUSKOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-870-0053
Mailing Address - Street 1:2707 AIRPORT FWY STE 203
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-2370
Mailing Address - Country:US
Mailing Address - Phone:871-870-0052
Mailing Address - Fax:817-336-9050
Practice Address - Street 1:2707 AIRPORT FWY STE 203
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-2370
Practice Address - Country:US
Practice Address - Phone:817-870-0073
Practice Address - Fax:817-336-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031647301Medicaid
TXD66769Medicare UPIN
TX00A22SMedicare ID - Type UnspecifiedMEDICARE ID