Healthcare Provider Details

I. General information

NPI: 1669249082
Provider Name (Legal Business Name): HELEN MOKHAYERI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 W STASSNEY LN
AUSTIN TX
78745-2947
US

IV. Provider business mailing address

31 RIPPLING CREEK DR
SUGAR LAND TX
77479-5875
US

V. Phone/Fax

Practice location:
  • Phone: 512-440-4800
  • Fax:
Mailing address:
  • Phone: 832-491-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1061301
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: