Provider Demographics
NPI:1508489741
Name:TANDEM PSYCHIATRIC AND FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:TANDEM PSYCHIATRIC AND FAMILY PRACTICE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL
Authorized Official - Prefix:
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:OKERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-528-5810
Mailing Address - Street 1:1219 DEEP RIVER DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6249
Mailing Address - Country:US
Mailing Address - Phone:281-404-5490
Mailing Address - Fax:281-404-5494
Practice Address - Street 1:4781 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4723
Practice Address - Country:US
Practice Address - Phone:281-404-5490
Practice Address - Fax:281-404-5494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty