Healthcare Provider Details

I. General information

NPI: 1588570329
Provider Name (Legal Business Name): EVERGROWTH PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15714 BALLATER RIDGE LN
HUMBLE TX
77346-4335
US

IV. Provider business mailing address

PO BOX 422
HUMBLE TX
77347-0422
US

V. Phone/Fax

Practice location:
  • Phone: 318-344-6943
  • Fax:
Mailing address:
  • Phone: 936-246-2579
  • Fax: 936-244-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY HORTON IZOBA
Title or Position: MANAGING MEMBER
Credential: PMHNP
Phone: 936-246-2579