MEDICARE: GREATER HEIGHTS HOLISTIC PSYCHIATRY

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	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669027413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER HEIGHTS HOLISTIC PSYCHIATRY

Provider Business Mailing Address
First Line	:	1111 NORTH LOOP W STE 900
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4716
Country	:	US
Telephone Number	:	832-930-1202
Fax Number	:	832-304-6385

Provider Business Practice Location Address
First Line	:	1919 NORTH LOOP W STE 280
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1368
Country	:	US
Telephone Number	:	832-930-1202
Fax Number	:	832-304-6385

Authorized Official
Title or Position	:	CEO
Name	:	DHARMENDRA KUMAR
Credential	:
Telephone Number	:	832-930-1202

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	11/19/2024

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Directions to “GREATER HEIGHTS HOLISTIC PSYCHIATRY ” Practice Location

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