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General NPI Number Information
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NPI Number | 1972015022
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Entity Type | Organization
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Legal Business Name | OASIS MIND AND BODY
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 3301 PLAINVIEW 1
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City | PASADENA
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State | TX
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Zip | 77504
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Country | US
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Telephone | 281-972-8870
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Fax | 346-802-2152
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Provider Business Mailing Address
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Address Line | 3301 PLAINVIEW 1
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City | PASADENA
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State | TX
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Zip | 77504
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Country | US
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Telephone | 281-972-8870
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Fax |
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Authorized Official
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Title or Position | OPERATION ASSISTANT
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Name | DIAMOND GALLOW
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Credential |
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Telephone | 281-612-9565
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 530639
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License Number State | TX
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