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General NPI Number Information
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NPI Number | 1972919553
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Entity Type | Organization
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Legal Business Name | HOPE PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 15992 TROWBRIDGE RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-7339
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Country | US
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Telephone | 573-529-1036
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1221
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City | BALLWIN
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State | MO
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Zip | 63022-1221
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Country | US
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Telephone | 573-529-1036
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BHASKAR GOWDA
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Credential | M.D.
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Telephone | 573-529-1036
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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 | 2002031642
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License Number State | MO
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