Healthcare Provider Details

I. General information

NPI: 1730636622
Provider Name (Legal Business Name): MELISSA FASTEAU WEINGAST PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA FASTEAU PSYD

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 LOUISIANA ST STE 200
HOUSTON TX
77006-6624
US

IV. Provider business mailing address

3303 LOUISIANA ST STE 200
HOUSTON TX
77006-6624
US

V. Phone/Fax

Practice location:
  • Phone: 713-424-8188
  • Fax: 713-424-8321
Mailing address:
  • Phone: 713-424-8188
  • Fax: 713-424-8321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number37637
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: