Healthcare Provider Details

I. General information

NPI: 1306672837
Provider Name (Legal Business Name): SUNSHINE FAMILY PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 HAWK WOOD LN
PROSPER TX
75078-2001
US

IV. Provider business mailing address

701 HAWK WOOD LN
PROSPER TX
75078-2001
US

V. Phone/Fax

Practice location:
  • Phone: 469-526-3474
  • Fax: 469-526-5628
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAM KHAN
Title or Position: BILLING MANAGER
Credential:
Phone: 512-201-6766