MEDICARE: MAVERICK PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1033928262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAVERICK PSYCHIATRY

Provider Business Mailing Address
First Line	:	10555 ACACIA PARK PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1243
Country	:	US
Telephone Number	:	917-244-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6415 S FORT APACHE RD STE 1851004
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-6744
Country	:	US
Telephone Number	:	702-530-7069
Fax Number	:

Authorized Official
Title or Position	:	PSYCHIATRIST/OWNER
Name	:	DR. PATRICK JANIK
Credential	:	DO
Telephone Number	:	917-244-6000

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	02/03/2025

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Directions to “MAVERICK PSYCHIATRY ” Practice Location

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