Provider Demographics
NPI:1770764466
Name:TRI CITY PSYCHIATRIC SERVICES, P.A.
Entity type:Organization
Organization Name:TRI CITY PSYCHIATRIC SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WASIQ
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:ZAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-473-7661
Mailing Address - Street 1:PO BOX 541177
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-1177
Mailing Address - Country:US
Mailing Address - Phone:817-200-6680
Mailing Address - Fax:
Practice Address - Street 1:3600 S COOPER ST
Practice Address - Street 2:#100
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3405
Practice Address - Country:US
Practice Address - Phone:817-200-6680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 363A00000X, 363L00000X
TXM77832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDO4480OtherMEDICARE RAILROAD
TX0070QUOtherBCBS
TX00Z404Medicare PIN