MEDICARE: PREMIER PSYCHIATRIC & SLEEP MEDICINE 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	2084P0800X	Psychiatry	PL6710	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	314479YSYF	MEDICARE PIN	TX
3	OTHOOO	MEDICARE UPIN	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992110886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER PSYCHIATRIC & SLEEP MEDICINE ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	2705 GOLDEN MEADOW CT
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75069-7440
Country	:	US
Telephone Number	:	469-600-3635
Fax Number	:	469-600-8101

Provider Business Practice Location Address
First Line	:	3608 PRESTON ROAD
Second Line	:	SUTIE 146
City	:	PLANO
State	:	TX
Zip	:	75093
Country	:	US
Telephone Number	:	469-600-3635
Fax Number	:	469-600-8101

Authorized Official
Title or Position	:	MD
Name	:	MR. JAWAD RIAZ
Credential	:	M.D.,
Telephone Number	:	972-985-7499

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	03/25/2015

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