MEDICARE: RIMI SANDHU PMHNP

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	1109325	TX

General Provider Information

NPI Number	:	1770287203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIMI SANDHU PMHNP

Provider Business Mailing Address
First Line	:	4319 COPPER SKY LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-6465
Country	:	US
Telephone Number	:	832-774-5219
Fax Number	:

Provider Business Practice Location Address
First Line	:	25329 BUDDE RD STE 702
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-1695
Country	:	US
Telephone Number	:	281-803-5882
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	03/28/2023

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