Provider Demographics
NPI:1669027413
Name:GREATER HEIGHTS HOLISTIC PSYCHIATRY
Entity type:Organization
Organization Name:GREATER HEIGHTS HOLISTIC PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DHARMENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-930-1202
Mailing Address - Street 1:1111 NORTH LOOP W STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-4716
Mailing Address - Country:US
Mailing Address - Phone:832-930-1202
Mailing Address - Fax:832-304-6385
Practice Address - Street 1:1919 NORTH LOOP W STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1368
Practice Address - Country:US
Practice Address - Phone:832-930-1202
Practice Address - Fax:832-304-6385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX403287201Medicaid