Provider Demographics
NPI:1801535414
Name:SOLID FOUNDATION PSYCHIATRY PLLC
Entity type:Organization
Organization Name:SOLID FOUNDATION PSYCHIATRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDEWOR
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:OSEVWE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:832-438-0330
Mailing Address - Street 1:10223 BROADWAY ST STE P381
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7880
Mailing Address - Country:US
Mailing Address - Phone:281-720-6272
Mailing Address - Fax:281-720-6272
Practice Address - Street 1:6302 BROADWAY ST STE 130
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7859
Practice Address - Country:US
Practice Address - Phone:832-438-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty