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NPI Code Detail

MEDICARE: GREATER HOUSTON PSYCHIATRIC ASSOCIATES, PLLC

MEDICARE: GREATER HOUSTON PSYCHIATRIC ASSOCIATES, PLLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1467667808
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER HOUSTON PSYCHIATRIC ASSOCIATES, PLLC
Provider Business Mailing Address
First Line : 4888 LOOP CENTRAL DR
Second Line : SUITE 510
City : HOUSTON
State : TX
Zip : 77081-2226
Country : US
Telephone Number : 713-346-1555
Fax Number : 713-346-1579
Provider Business Practice Location Address
First Line : 4888 LOOP CENTRAL DR
Second Line : SUITE 510
City : HOUSTON
State : TX
Zip : 77081-2226
Country : US
Telephone Number : 713-346-1555
Fax Number : 713-346-1579
Authorized Official
Title or Position : ADMINISTRATOR
Name : DOUGLAS OLIVER BLACKARD
Credential :
Telephone Number : 713-208-0990
Provider Enumeration Date : 05/11/2007
Last Update Date : 08/23/2021

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