PBH Professional Group, P.a.

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

Legal business name

PBH PROFESSIONAL GROUP, P.A.

Doing business as

PATH Brazos Valley Professional Group

Practice address

3550 Normand Dr Ste 100
College Station, TX 77845-6399

Phone

(979) 218-5916

Fax

(979) 401-4170

NPI assigned

Jul 29, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Flora Sadri-Azarbayejani, D.O.

Title

President and Secretary

Phone

(413) 522-9246

Specialties & licenses 5

Addresses

Other names 1

• PATH Brazos Valley Professional Group Doing business as

Tax ID family

Path 5Palms Professional Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• PBH Professional Group, P.a.

  • Nurse Practitioner
  • Euless, TX
  • NPI 1932786290
  NPD tax ID
• PBH Professional Group, P.a.

  dba PATH Worcester Professional Group

  • Multi-Specialty Clinic/Center
  • Worcester, MA
  • NPI 1457945446
  NPD tax ID
• PBH Professional Group, P.a.

  dba PATH 5Palms Professional Group

  • Addiction Medicine (Preventive Medicine) Physician
  • Ormond Beach, FL
  • NPI 1912670647
  NPD tax ID
• PBH Professional Group, P.a.

  dba PATH Nashville Professional Group

  • Addiction Medicine (Preventive Medicine) Physician
  • Nashville, TN
  • NPI 1982273637
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1124791744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 POWELL CT STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275050",
            "telephone_number": "615-308-7871",
            "fax_number": "615-261-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 NORMAND DR STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456399",
            "telephone_number": "979-218-5916",
            "fax_number": "979-401-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBH PROFESSIONAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "SADRI-AZARBAYEJANI",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "413-522-9246",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATH Brazos Valley Professional Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Pavliska, PT
• Kiersten Faith Pawlik, RBT
• Jamie Pawlowski, M.D.
• Mary Payne, LCSW
• PB Behavioral Brazos Valley, LLC (Promises Brazos Valley)
• Peach Creek Alf 1 LLC (Peach Creek Assisted Living Facility)
• Roger Peart, PHARM.D.,R.PH
• Allison Faye Pedersen, MSN, APRN, FNP-BC
• Kevin Y Pei, M.D.
• Christopher Ronald Peoples, PHARM.D., RPH.

• Addiction Medicine (Preventive Medicine) Physician in College Station, TX
• Providers in College Station, TX by specialty
• Addiction Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.