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General NPI Number Information
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NPI Number | 1902532591
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Entity Type | Organization
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Legal Business Name | CENTER FOR INTEGRATIVE PSYCHIATRY
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 580 S DENTON TAP RD STE 280
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City | COPPELL
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State | TX
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Zip | 75019-4073
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Country | US
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Telephone | 917-287-8207
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Fax |
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Provider Business Mailing Address
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Address Line | 580 S DENTON TAP RD STE 280
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City | COPPELL
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State | TX
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Zip | 75019-4073
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Country | US
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Telephone | 917-287-8207
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAHIR N KHWAJA
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Credential | MD
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Telephone | 917-287-8207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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