Provider Demographics
NPI:1609325521
Name:HEALTHY MINDS PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:HEALTHY MINDS PSYCHIATRY, PLLC
Other - Org Name:HEALTHY MINDS PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRIEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUL-FOTOUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-396-0106
Mailing Address - Street 1:2000 DAIRY ASHFORD
Mailing Address - Street 2:STE 340
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077
Mailing Address - Country:US
Mailing Address - Phone:713-396-0106
Mailing Address - Fax:832-318-6278
Practice Address - Street 1:2000 S DAIRY ASHFORD RD
Practice Address - Street 2:STE 340
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5700
Practice Address - Country:US
Practice Address - Phone:713-396-0106
Practice Address - Fax:832-318-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9496103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1437394293OtherNPI
TX1609325521OtherORGANIZATION NPI
TXD16083Medicare UPIN