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General NPI Number Information
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NPI Number | 1073163093
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Entity Type | Organization
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Legal Business Name | MIND & BRAIN, PC
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 9432 KATY FWY STE 460
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City | HOUSTON
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State | TX
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Zip | 77055-6349
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Country | US
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Telephone | 832-699-7922
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Fax | 833-377-0446
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Provider Business Mailing Address
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Address Line | 9432 KATY FWY STE 460
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City | HOUSTON
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State | TX
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Zip | 77055-6349
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Country | US
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Telephone | 832-699-7922
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Fax | 832-780-5341
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Authorized Official
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Title or Position | MANAGER
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Name | CRISTIN RODRIGUEZ
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Credential |
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Telephone | 832-699-7922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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