Healthcare Provider Details

I. General information

NPI: 1609502160
Provider Name (Legal Business Name): DAVID MEJIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 MEDICAL PKWY
ENTERPRISE OR
97828-5140
US

IV. Provider business mailing address

3615 SINGLE RIDGE WAY
KATY TX
77493-7303
US

V. Phone/Fax

Practice location:
  • Phone: 832-433-3552
  • Fax:
Mailing address:
  • Phone: 832-671-0013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106826
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number106826
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: