Individual provider Active NPI

Tawakalitu Raji, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Humble, TX
National Provider Identifier
1841817020
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1020141 Issued in TX
Practice address
9816 Memorial Blvd Ste 207
Humble, TX 77338-4206
Phone
(281) 886-8595
Fax
(281) 884-3616
NPI assigned
Jul 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 767462 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1020141 TX Primary

Addresses

Primary practice location

9816 Memorial Blvd Ste 207
Humble, TX 77338-4206

Mailing address

10047 Small Pebble Way
Humble, TX 77396-3060
Phone (281) 886-8595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210212001940 TX Practitioner - Nurse Practitioner 0648685297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9816 Memorial Blvd
Suite 100
Humble, TX 77338-4205
Phone (281) 886-8595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
767462TXMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC Current Accepting new patients
Favor Healthcare Services LLC Psychiatric/Mental Health CurrentSince Jan 1, 2022 Accepting new patients

Locations

9816 Memorial Blvd
Ste 100
Humble, TX 77338
Phone (281) 886-8595

9816 Memorial Blvd
Ste 207
Humble, TX 77338
Phone (281) 886-8595

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1841817020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10047 SMALL PEBBLE WAY",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773963060",
            "telephone_number": "281-886-8595",
            "fax_number": "281-884-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9816 MEMORIAL BLVD STE 207",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384206",
            "telephone_number": "281-886-8595",
            "fax_number": "281-884-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJI",
        "first_name": "TAWAKALITU",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-03",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "767462",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1020141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.