Provider Demographics
NPI:1639817513
Name:ANAVOTA BEHAVIORAL HEALTH PLLC
Entity Type:Organization
Organization Name:ANAVOTA BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:NKEMDILIM
Authorized Official - Last Name:AKINBILE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-834-3830
Mailing Address - Street 1:6666 HARWIN DR STE 155
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2495
Mailing Address - Country:US
Mailing Address - Phone:832-834-3830
Mailing Address - Fax:
Practice Address - Street 1:10750 BARKER CYPRESS RD STE 104
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2282
Practice Address - Country:US
Practice Address - Phone:877-895-5496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)