Healthcare Provider Details

I. General information

NPI: 1407667082
Provider Name (Legal Business Name): TALA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 LOUISIANA ST STE 313
HOUSTON TX
77002-4951
US

IV. Provider business mailing address

801 LOUISIANA ST STE 313
HOUSTON TX
77002-4951
US

V. Phone/Fax

Practice location:
  • Phone: 415-275-0945
  • Fax:
Mailing address:
  • Phone: 415-275-0945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: QINGQING MAO
Title or Position: CTO
Credential:
Phone: 415-805-1725