Basic Information
| Provider Information | |||||||||
| NPI: | 1770095895 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SBH TEXAS PHYSICIAN SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8295 TOURNAMENT DR STE 201 | ||||||||
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| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381258913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9019693120 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3550 NORMAND DR | ||||||||
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| City: | COLLEGE STATION | ||||||||
| State: | TX | ||||||||
| PostalCode: | 778456399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9797038848 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2017 | ||||||||
| LastUpdateDate: | 05/20/2021 | ||||||||
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| AuthorizedOfficialLastName: | CAGLE | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9019693114 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | N | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.