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General NPI Number Information
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NPI Number | 1184238826
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Entity Type | Organization
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Legal Business Name | BRIGHT STONE PSYCHIATRY
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 12/28/2020
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Provider Practice Location Address
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Address Line | 2626 S LOOP W STE 525
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City | HOUSTON
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State | TX
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Zip | 77054-2654
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Country | US
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Telephone | 832-378-8282
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 S LOOP W STE 525
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City | HOUSTON
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State | TX
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Zip | 77054-2654
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Country | US
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Telephone | 832-378-8282
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Fax |
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Authorized Official
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Title or Position | PMHNP/PART OWNER
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Name | CANDRA SMITH
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Credential | PMHNP
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Telephone | 832-524-6643
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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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