Texas Online Psychiatry, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

TEXAS ONLINE PSYCHIATRY, PLLC

Practice address

719 Sawdust Rd Ste 210
Spring, TX 77380-2947

Phone

(346) 202-7570

Fax

(346) 202-7571

NPI assigned

Jul 13, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jared Heathman, MDNPI 1972820215

Title

Managing Member

Phone

(346) 202-7570

Specialties & licenses 1

Addresses

Other names 1

• Mynd Psychiatry Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jared Heathman, MD

  • Psychiatry Physician
  • Cypress, TX
  • NPI 1972820215
  NPD Authorized official
• John Patrick Gillespie, LCSW

  • Clinical Social Worker
  • Spring, TX
  • NPI 1790678522
  NPD
• Kedwina Remy Ndukwu, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spring, TX
  • NPI 1740155084
  NPD
• Cynthia Frieda Kowalis

  • Professional Counselor
  • Spring, TX
  • NPI 1790616209
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1487388641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17934 FERNWOOD BEND DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773772459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 SAWDUST RD STE 210",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773802947",
            "telephone_number": "346-202-7570",
            "fax_number": "346-202-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS ONLINE PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "HEATHMAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "346-202-7570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mynd Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatry Physician in Spring, TX
• Providers in Spring, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.