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PHOENIX MEDICAL ASSOCIATES NPI 1790736239


NPI Information

NPI: 1790736239
Provider Name: PHOENIX MEDICAL ASSOCIATES
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
222 SIDNEY BAKER SOUTH
SUITE 500
KERRVILLE, TX
ZIP 78028
Phone: (830) 895-7675
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PHOENIX MEDICAL ASSOCIATES is an addiction medicine psychiatry neurology in Kerrville, TX. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine PHOENIX MEDICAL ASSOCIATES NPI is 1790736239. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

222 SIDNEY BAKER SOUTH
SUITE 500
KERRVILLE, TX
ZIP 78028-900
Phone: (830) 895-7675
Fax: (830) 896-3082

The provider's authorized official is Anand W. Mehendale .
The authorized official title is President and has the following contact phone number (830) 895-7675.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 9/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084A0401XPsychiatry & NeurologyAddiction MedicineG1112TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100564KOTHERTEXASMEDICARE PTAN
2080790101MEDICAIDTEXAS
30093CZOTHERTEXASBLUE CROSS BLUE SHIELD
4CJ3940OTHERTEXASRAILROAD MEDICARE
5B24829MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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