Provider Demographics
NPI:1750765368
Name:SBN PROFESSIONAL PSYCHIATRY CORP
Entity type:Organization
Organization Name:SBN PROFESSIONAL PSYCHIATRY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BUSHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-320-9000
Mailing Address - Street 1:3025 E. RENNER ROAD
Mailing Address - Street 2:#120
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082
Mailing Address - Country:US
Mailing Address - Phone:972-295-9008
Mailing Address - Fax:972-688-6169
Practice Address - Street 1:3025 E. RENNER ROAD
Practice Address - Street 2:#120
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082
Practice Address - Country:US
Practice Address - Phone:972-295-9008
Practice Address - Fax:972-688-6169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty