Provider Demographics
NPI:1982479176
Name:HAMADA HEALING CENTER
Entity Type:Organization
Organization Name:HAMADA HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:YOSHIKO
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:601-504-0180
Mailing Address - Street 1:675 TOWN SQUARE BLVD BLDG 1A
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2992
Mailing Address - Country:US
Mailing Address - Phone:601-504-0180
Mailing Address - Fax:
Practice Address - Street 1:675 TOWN SQUARE BLVD BLDG 1A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2992
Practice Address - Country:US
Practice Address - Phone:601-504-0180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty