Active NPI
Fahdeela Memon, PSYD
- Clinical Psychologist
- Houston, TX
National Provider Identifier
1841702636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 36898
- Practice address
- 2603 Augusta Dr Ste 260
Houston, TX 77057-5638 - Phone
- (713) 487-9310
- NPI assigned
- Nov 1, 2017
- Last updated
- Nov 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 36898 | TX | Primary |
Addresses
Primary practice location
2603 Augusta Dr Ste 260
Houston, TX 77057-5638
Mailing address
PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36898 | TX | MD | Periodontist |
| 36868 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509494400000",
"number": "1841702636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2257",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463040357",
"telephone_number": "219-926-8320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2603 AUGUSTA DR STE 260",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770575638",
"telephone_number": "713-487-9310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEMON",
"first_name": "FAHDEELA",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-01",
"last_updated": "2017-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.