NPIMap

Organization Active NPI

Adult Child & Adolescent Psychiatric Services PA

  • Psychiatry Physician
  • Plano, TX
National Provider Identifier
1194036459
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ADULT CHILD & ADOLESCENT PSYCHIATRIC SERVICES PA
Practice address
5501 Independence Pkwy Ste 302
Plano, TX 75023-5470
Phone
(469) 747-1010
NPI assigned
Jul 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Authorized official

Name
Mohammad S Khan, MDNPI 1528028032
Title
Owner
Phone
(972) 709-7556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5501 Independence Pkwy Ste 302
Plano, TX 75023-5470

Mailing address

P O Box 2755
McKinney, TX 75070
Phone (469) 747-1010

Other identifiers 1

IdentifierTypeStateIssuer
1194036459OtherTXNPI GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120920000429 TX Part B Supplier - Clinic/Group Practice 0244488054 Receives reassigned benefits from 12 practitioners
Practice locations: McKinney, TX; Plano, TX; Lancaster, TX

National Provider Directory

National Provider Directory

Locations

2140 N Lake Forest Dr
#104
McKinney, TX 75071
Phone (469) 747-1010

1740 W Virginia St
Ste 200
McKinney, TX 75069
Phone (469) 747-1010

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1194036459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 2755",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "75070",
            "telephone_number": "469-747-1010",
            "fax_number": "469-747-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 INDEPENDENCE PKWY STE 302",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235470",
            "telephone_number": "469-747-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT CHILD & ADOLESCENT PSYCHIATRIC SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-01",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-709-7556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1194036459",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.