Provider Demographics
NPI:1134936636
Name:MERCYANGEL BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MERCYANGEL BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IHUOMA
Authorized Official - Middle Name:UKO
Authorized Official - Last Name:UDEH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-921-5087
Mailing Address - Street 1:26943 CHURCHILL GATE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26943 CHURCHILL GATE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5237
Practice Address - Country:US
Practice Address - Phone:832-921-5087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty