=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225451776
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIEDMONT BEHAVIORAL SERVICES, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2014
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17070 RED OAK DR STE 303
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77090-2616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-297-2930
-----------------------------------------------------
Fax | 877-630-9339
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 PRESTON EXECUTIVE DR STE 102
-----------------------------------------------------
City | CARY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27513-8433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-297-2930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | IJAZ RASUL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 601-622-5652
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 2012-01584
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------