NPIMap

Organization Active NPI

Tandem Psychiatric and Family Practice PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Stafford, TX
National Provider Identifier
1508489741
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TANDEM PSYCHIATRIC AND FAMILY PRACTICE PLLC
Practice address
4781 S Main St
Stafford, TX 77477-4723
Phone
(281) 404-5490
Fax
(281) 404-5494
NPI assigned
May 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Nelly OkereNPI 1326580705
Title
Credential
Phone
(832) 528-5810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4781 S Main St
Stafford, TX 77477-4723

Mailing address

1219 Deep River Dr
Richmond, TX 77469-6249
Phone (281) 404-5490

Other names 1

  • PLLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201014001814 TX Part B Supplier - Clinic/Group Practice 7911327887 Receives reassigned benefits from 3 practitioners
Practice locations: Stafford, TX

National Provider Directory

National Provider Directory

Locations

4781 S Main St
Stafford, TX 77477
Phone (281) 404-5490

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1508489741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 DEEP RIVER DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774696249",
            "telephone_number": "281-404-5490",
            "fax_number": "281-404-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4781 S MAIN ST",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774723",
            "telephone_number": "281-404-5490",
            "fax_number": "281-404-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANDEM PSYCHIATRIC AND FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "OKERE",
        "authorized_official_first_name": "NELLY",
        "authorized_official_title_or_position": "CREDENTIAL",
        "authorized_official_telephone_number": "832-528-5810"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.