Provider Demographics
NPI:1871607192
Name:ASSOCIATES OF FAMILY PSYCHIATRY,P.A
Entity type:Organization
Organization Name:ASSOCIATES OF FAMILY PSYCHIATRY,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-285-8900
Mailing Address - Street 1:669 AIRPORT FWY
Mailing Address - Street 2:STE 301
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-3970
Mailing Address - Country:US
Mailing Address - Phone:817-285-8900
Mailing Address - Fax:817-285-8903
Practice Address - Street 1:669 AIRPORT FWY
Practice Address - Street 2:STE 301
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-3970
Practice Address - Country:US
Practice Address - Phone:817-285-8900
Practice Address - Fax:817-285-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ06442084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0028LXOtherBCBS GROUP NUMBER
TX0028LXOtherBCBS GROUP NUMBER
TX00528ZMedicare PIN
TX8F1167Medicare PIN