MEDICARE: STACY WYATT

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	1158846	TX

General Provider Information

NPI Number	:	1861222143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY WYATT

Provider Business Mailing Address
First Line	:	4801 WOODWAY DR STE 306W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-1828
Country	:	US
Telephone Number	:	832-225-3345
Fax Number	:	713-583-1504

Provider Business Practice Location Address
First Line	:	4801 WOODWAY DR STE 306W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-1828
Country	:	US
Telephone Number	:	832-225-3345
Fax Number	:	713-583-1504

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

Provider Enumeration Date	:	08/02/2024
Last Update Date	:	08/02/2024

Similar Medicare Providers

1285114454 — PSYCH MATTERS PLLC
Practice Location Address:

4801 WOODWAY DR STE 306W
HOUSTON, TX
77056-1828

Practice Phone: 832-225-3345
Practice Fax:

1639893902 — SUSANA JIMENEZ LPC-A
Practice Location Address:

4801 WOODWAY DR STE 306W
HOUSTON, TX
77056-1828

Practice Phone: 832-225-3345
Practice Fax: 713-583-1504

1801786306 — ANNIKA DALBRATT
Practice Location Address:

4801 WOODWAY DR STE 306W
HOUSTON, TX
77056-1828

Practice Phone: 832-225-3345
Practice Fax: 713-583-1504

1063390565 — ISSIS N ELVIR
Practice Location Address:

4801 WOODWAY DR STE 306W
HOUSTON, TX
77056-1828

Practice Phone: 832-225-3345
Practice Fax:

1083652549 — MEDICINE ON THE GO EMS
Practice Location Address:

10919 FAIRCROFT DR
HOUSTON, TX
77048-1828

Practice Phone: 281-477-3808
Practice Fax: 281-477-3686

1609964113 — DR. THOMAS P BUI OD
Practice Location Address:

1828 AIRLINE DR , SUITE A
HOUSTON, TX
77009-2952

Practice Phone: 713-802-9963
Practice Fax:

Directions to “ STACY WYATT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.