Active Minds RX PLLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Hungerford, TX
NPI 1073207809 · NPPES record last updated Jun 5, 2023
Key facts
- NPI
- 1073207809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- ACTIVE MINDS RX PLLC
- Practice address
- 210 E Live Oak St
Hungerford, TX 77448-0135 - Phone
- (713) 816-5646
- NPI assigned
- Jun 5, 2023
- Organization subpart
- No
Authorized official
- Name
- Edward John Kazmir, NP
- Title
- Authorized Official
- Phone
- (713) 816-5646
National Provider Directory
Locations
210 E Live Oak St
Hungerford, TX 77448
Phone (713) 816-5646
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
210 E Live Oak St
Hungerford, TX 77448-0135
Mailing address
PO Box 511
Hungerford, TX 77448-0511
Phone (713) 816-5646
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.