Provider Demographics
NPI:1790423770
Name:TYESHA ALEXANDER PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:TYESHA ALEXANDER PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYESHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:414-520-6943
Mailing Address - Street 1:8211 BOSPHORUS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1718
Mailing Address - Country:US
Mailing Address - Phone:414-520-6943
Mailing Address - Fax:
Practice Address - Street 1:340 N SAM HOUSTON PKWY E STE A254D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3305
Practice Address - Country:US
Practice Address - Phone:414-520-6943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health