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General NPI Number Information
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NPI Number | 1871213074
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Entity Type | Organization
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Legal Business Name | WEST PSYCHIATRY LLC
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | CENTRO PLAZA OFIC 3B 63 CALLE MENDEZ VIGO ESTE
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-504-2599
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Fax |
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Provider Business Mailing Address
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Address Line | CENTRO PLAZA OFIC 3B 63 CALLE MENDEZ VIGO ESTE
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-504-2599
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DIMAS J TIRADO
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Credential | MD
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Telephone | 787-504-2599
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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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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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