Basic Information
| Provider Information | |||||||||
| NPI: | 1023676574 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENSUS PSYCHIATRIC SOLUTIONS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10250 JOHN SAUNDERS RD UNIT 460625 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782462420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104682015 | ||||||||
| FaxNumber: | 2104682355 | ||||||||
| Practice Location | |||||||||
| Address1: | 8550 HUEBNER RD | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105415300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2019 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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| AuthorizedOfficialLastName: | MICHELSEN | ||||||||
| AuthorizedOfficialFirstName: | SOAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | SOLE MBR | ||||||||
| AuthorizedOfficialTelephone: | 2104682015 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.