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General NPI Number Information
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NPI Number | 1811267727
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Entity Type | Organization
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Legal Business Name | INNOVATED MINDS PA
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Dates
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Enumeration Date | 01/09/2012
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 1029 LONG PRAIRIE RD STE D
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City | FLOWER MOUND
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State | TX
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Zip | 75022-4243
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Country | US
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Telephone | 817-684-2710
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Fax | 972-724-2111
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Provider Business Mailing Address
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Address Line | 1029 LONG PRAIRIE RD STE D
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City | FLOWER MOUND
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State | TX
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Zip | 75022-4243
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Country | US
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Telephone | 817-684-2710
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Fax | 972-724-2111
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Authorized Official
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Title or Position | OWNER
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Name | DR. SYED QUADRI
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Credential | MD
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Telephone | 817-684-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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