Healthcare Provider Details

I. General information

NPI: 1275983561
Provider Name (Legal Business Name): BEHAVIORAL HEALTH SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 09/29/2023
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 LACE PT
SPRING TX
77382-1703
US

IV. Provider business mailing address

3 LACE PT
SPRING TX
77382-1703
US

V. Phone/Fax

Practice location:
  • Phone: 585-203-7308
  • Fax:
Mailing address:
  • Phone: 585-203-7308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROOPA CHALLAPALLI
Title or Position: MEMBER
Credential: M.D.,
Phone: 585-203-7576