MEDICARE: RISING MIND PSYCHIATRY 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1639034945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING MIND PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	550 GREENS PKWY STE 203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067-4538
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 GREENS PKWY STE 203
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067-4538
Country	:	US
Telephone Number	:	734-262-5843
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ PROVIDER
Name	:	MAMOONA HAMEED KHAN
Credential	:
Telephone Number	:	734-262-5843

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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