Provider Demographics
NPI:1376324483
Name:PEACEFUL PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:PEACEFUL PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUNITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNASAMY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:361-815-8892
Mailing Address - Street 1:6033 ORIENTAL AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4093
Mailing Address - Country:US
Mailing Address - Phone:361-815-8892
Mailing Address - Fax:
Practice Address - Street 1:1546 S BROWNLEE BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3142
Practice Address - Country:US
Practice Address - Phone:361-886-6970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty