MEDICARE: SUMMIT PSYCHIATRIC ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	Q7562	TX
2	2084P0800X	Psychiatry Physician	Q7562	TX

General Provider Information

NPI Number	:	1063954766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT PSYCHIATRIC ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 451178
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75045-1178
Country	:	US
Telephone Number	:	469-573-1890
Fax Number	:

Provider Business Practice Location Address
First Line	:	2696 W WALNUT ST
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6441
Country	:	US
Telephone Number	:	469-573-1890
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. SHAHID HUSSAIN HUSSAIN
Credential	:	MD
Telephone Number	:	469-573-1890

Provider Enumeration Date	:	11/11/2016
Last Update Date	:	12/04/2025

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