Provider Demographics
NPI:1003463506
Name:GHANCHI, MEHREEN
Entity Type:Individual
Prefix:
First Name:MEHREEN
Middle Name:
Last Name:GHANCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEHREEN
Other - Middle Name:
Other - Last Name:GHANCHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:308 S FRIENDSWOOD DR STE 110
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3989
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:
Practice Address - Street 1:308 S FRIENDSWOOD DR STE 110
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3989
Practice Address - Country:US
Practice Address - Phone:210-589-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143243363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty