Healthcare Provider Details

I. General information

NPI: 1023928090
Provider Name (Legal Business Name): SVETLANA ZAKINOV PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LANA ZAKINOV PSYD

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21212 NORTHWEST FWY STE 455
CYPRESS TX
77429-6070
US

IV. Provider business mailing address

21212 NORTHWEST FWY STE 455
CYPRESS TX
77429-6070
US

V. Phone/Fax

Practice location:
  • Phone: 832-237-2673
  • Fax: 832-237-2676
Mailing address:
  • Phone: 832-237-2673
  • Fax: 832-237-2676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number41320
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: