Healthcare Provider Details

I. General information

NPI: 1225977036
Provider Name (Legal Business Name): AXIS PSYCHIATRIC SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3298 STARKVILLE ST
SAINT CHARLES MO
63301-8506
US

IV. Provider business mailing address

3298 STARKVILLE ST
SAINT CHARLES MO
63301-8506
US

V. Phone/Fax

Practice location:
  • Phone: 636-851-7262
  • Fax: 636-851-7262
Mailing address:
  • Phone: 636-851-7262
  • Fax: 636-851-7262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FAISAL MOHAMMAD MATAR
Title or Position: PRESIDENT
Credential: APRN
Phone: 636-851-7262