=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447667852
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW HOPE TMS DEPRESSION THERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2014
-----------------------------------------------------
Last Update Date | 07/17/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21320 PROVINCIAL BLVD # 100
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77450-7580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-825-2310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21320 PROVINCIAL BLVD # 100
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77450-7580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-825-2310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. NORA CATHERINE HART
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 281-825-2310
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | M3576
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------