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NPI Code Detail

MEDICARE: AFTER HOURS PSYCHIATRY INNER LOOP, PLLC

MEDICARE: AFTER HOURS PSYCHIATRY INNER LOOP, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1306309760
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFTER HOURS PSYCHIATRY INNER LOOP, PLLC
Provider Business Mailing Address
First Line : 5959 WEST LOOP S STE 600
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2425
Country : US
Telephone Number : 713-981-0660
Fax Number :
Provider Business Practice Location Address
First Line : 5959 W LOOP S #600
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2425
Country : US
Telephone Number : 713-981-0660
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KATHLEEN ANN DEE
Credential : NP
Telephone Number : 713-981-0660
Provider Enumeration Date : 04/11/2019
Last Update Date : 04/11/2019

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