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General NPI Number Information
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NPI Number | 1033928262
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Entity Type | Organization
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Legal Business Name | MAVERICK PSYCHIATRY
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 6415 S FORT APACHE RD STE 1851004
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City | LAS VEGAS
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State | NV
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Zip | 89148-6744
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Country | US
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Telephone | 702-530-7069
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Fax |
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Provider Business Mailing Address
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Address Line | 10555 ACACIA PARK PL
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City | LAS VEGAS
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State | NV
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Zip | 89135-1243
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Country | US
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Telephone | 917-244-0000
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST/OWNER
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Name | DR. PATRICK JANIK
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Credential | DO
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Telephone | 917-244-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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