Provider Demographics
NPI:1275171639
Name:INFINITY BEHAVIORAL HEALTH OF TEXAS
Entity Type:Organization
Organization Name:INFINITY BEHAVIORAL HEALTH OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MERIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-278-6607
Mailing Address - Street 1:4739 QUEENS CARRIAGE ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-3230
Mailing Address - Country:US
Mailing Address - Phone:225-278-6607
Mailing Address - Fax:
Practice Address - Street 1:363 N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-2404
Practice Address - Country:US
Practice Address - Phone:225-278-6607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health