Provider Demographics
NPI:1588081962
Name:PERFECT BALANCE PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:PERFECT BALANCE PSYCHIATRIC SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUBNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-781-0100
Mailing Address - Street 1:9300 JOHN HICKMAN PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5939
Mailing Address - Country:US
Mailing Address - Phone:972-781-0100
Mailing Address - Fax:972-781-0101
Practice Address - Street 1:9300 JOHN HICKMAN PKWY STE 101
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5939
Practice Address - Country:US
Practice Address - Phone:972-781-0100
Practice Address - Fax:972-781-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM13472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352668ZG1QMedicare PIN