Healthcare Provider Details

I. General information

NPI: 1710276225
Provider Name (Legal Business Name): PSYCHIATRIC INPATIENT MANAGEMENT SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8026 FLOYD CURL DR
SAN ANTONIO TX
78229-3915
US

IV. Provider business mailing address

7711 LOUIS PASTEUR DR SUITE 708
SAN ANTONIO TX
78229-3415
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-8229
  • Fax: 210-575-4013
Mailing address:
  • Phone: 210-575-8229
  • Fax: 210-575-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBERTA S. CLOUD
Title or Position: VICE PRESIDENT
Credential:
Phone: 210-575-8501