Provider Demographics
NPI:1952187395
Name:MERIDIAN PSYCHIATRY AND WELLNESS,PLLC
Entity Type:Organization
Organization Name:MERIDIAN PSYCHIATRY AND WELLNESS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MS
Authorized Official - First Name:JUSTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:832-646-1394
Mailing Address - Street 1:6671 SOUTHWEST FWY STE 690
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2212
Mailing Address - Country:US
Mailing Address - Phone:281-306-3932
Mailing Address - Fax:
Practice Address - Street 1:6671 SOUTHWEST FWY STE 690
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2212
Practice Address - Country:US
Practice Address - Phone:281-306-3932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty