Provider Demographics
NPI:1558603068
Name:SETHNA, JIMMY P (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:P
Last Name:SETHNA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17115 RED OAK DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2641
Mailing Address - Country:US
Mailing Address - Phone:281-397-0200
Mailing Address - Fax:
Practice Address - Street 1:17115 RED OAK DR
Practice Address - Street 2:SUITE 220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2641
Practice Address - Country:US
Practice Address - Phone:281-397-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36319103G00000X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical