Provider Demographics
NPI:1457935314
Name:CAIN, ANGELA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CAIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-2498
Mailing Address - Country:US
Mailing Address - Phone:281-508-1839
Mailing Address - Fax:
Practice Address - Street 1:2627 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-1114
Practice Address - Country:US
Practice Address - Phone:713-970-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036825364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health