MEDICARE: MIND HAVEN PSYCHIATRY

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1588526040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND HAVEN PSYCHIATRY

Provider Business Mailing Address
First Line	:	6255 W NORTHWEST HWY APT 608
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-3588
Country	:	US
Telephone Number	:	469-209-9161
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 US 287 FRONTAGE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-7600
Country	:	US
Telephone Number	:	785-608-0450
Fax Number	:

Authorized Official
Title or Position	:	PSYCHIATRIST
Name	:	RISHI PATEL
Credential	:	DO
Telephone Number	:	469-209-9161

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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