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General NPI Number Information
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NPI Number | 1104643394
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Entity Type | Organization
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Legal Business Name | LET TAS PSYCHIATRY SERVICES LLC
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Dates
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Enumeration Date | 09/20/2024
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 11301 RICHMOND AVE STE K109
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City | HOUSTON
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State | TX
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Zip | 77082-5549
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Country | US
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Telephone | 817-526-8952
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Fax | 281-845-7782
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Provider Business Mailing Address
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Address Line | 11301 RICHMOND AVE STE K109
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City | HOUSTON
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State | TX
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Zip | 77082-5549
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Country | US
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Telephone | 281-752-6895
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AGNES BENJAMIN
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Credential | APRN
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Telephone | 281-752-6895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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