Provider Demographics
NPI:1982122230
Name:IANDI CONSULTING PLLC
Entity Type:Organization
Organization Name:IANDI CONSULTING PLLC
Other - Org Name:CARE BRIDGE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:INYENE
Authorized Official - Middle Name:E
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-784-4753
Mailing Address - Street 1:1008 DAVID DUVAL CV
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5820
Mailing Address - Country:US
Mailing Address - Phone:404-784-4753
Mailing Address - Fax:
Practice Address - Street 1:3000 JOE DIMAGGIO BLVD STE 62
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3996
Practice Address - Country:US
Practice Address - Phone:512-582-3424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health