MEDICARE: OPTIMA FORENSIC PSYCHOLOGICAL SERVICES

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	103TF0200X	Forensic Psychologist

General Provider Information

NPI Number	:	1972396513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMA FORENSIC PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	2700 RESEARCH FOREST DR STE 130
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-4252
Country	:	US
Telephone Number	:	281-528-4226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 RESEARCH FOREST DR STE 130
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-4252
Country	:	US
Telephone Number	:	281-528-4226
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SARAH HOLUB
Credential	:	M.ED.
Telephone Number	:	281-528-4226

Provider Enumeration Date	:	05/27/2025
Last Update Date	:	05/27/2025

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