Provider Demographics
NPI:1083490429
Name:TEXAS MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:TEXAS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:804-728-7499
Mailing Address - Street 1:1330 PARK WEST GREEN DR APT 5303
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3969
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1330 PARK WEST GREEN DR APT 5303
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3969
Practice Address - Country:US
Practice Address - Phone:804-728-7499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health