Healthcare Provider Details

I. General information

NPI: 1225549413
Provider Name (Legal Business Name): MY BRIGHT FUTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2017
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 S LOOP W STE 430
HOUSTON TX
77054-2649
US

IV. Provider business mailing address

2626 S LOOP W STE 430
HOUSTON TX
77054-2649
US

V. Phone/Fax

Practice location:
  • Phone: 713-589-5363
  • Fax: 713-589-3608
Mailing address:
  • Phone: 713-589-5363
  • Fax: 713-589-5363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. AMEISHA SCOTT
Title or Position: MANAGER
Credential: NURSE PRACTITIONER
Phone: 713-589-5363