MEDICARE: CHA BEHAVIORAL HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	Q0400	TX

General Provider Information

NPI Number	:	1376089482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHA BEHAVIORAL HEALTHCARE

Provider Business Mailing Address
First Line	:	3227 PINE DUST LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-9217
Country	:	US
Telephone Number	:	513-574-0055
Fax Number	:	513-574-1950

Provider Business Practice Location Address
First Line	:	201 KINGWOOD MEDICAL DR
Second Line	:	SUITE A450
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6006
Country	:	US
Telephone Number	:	832-701-0283
Fax Number	:	281-608-7543

Authorized Official
Title or Position	:	OWNER
Name	:	HILARY C AKPUDO
Credential	:	M.D.
Telephone Number	:	513-574-0055

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	03/07/2017

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Directions to “CHA BEHAVIORAL HEALTHCARE ” Practice Location

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