Provider Demographics
NPI:1891352548
Name:KAY PSYCHIATRIC CENTER PLLC
Entity Type:Organization
Organization Name:KAY PSYCHIATRIC CENTER PLLC
Other - Org Name:KAY BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAPO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:832-952-9688
Mailing Address - Street 1:14405 WALTERS RD STE 860
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1385
Mailing Address - Country:US
Mailing Address - Phone:832-952-9688
Mailing Address - Fax:
Practice Address - Street 1:14405 WALTERS RD STE 860
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1385
Practice Address - Country:US
Practice Address - Phone:832-952-9688
Practice Address - Fax:312-586-7238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2120963Medicaid
TX404952001Medicaid