Provider Demographics
NPI:1730937905
Name:GOLD MIND PSYCHIATRY
Entity type:Organization
Organization Name:GOLD MIND PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MBUA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:281-901-0044
Mailing Address - Street 1:11754 GIOVANNI LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1535
Mailing Address - Country:US
Mailing Address - Phone:281-901-0044
Mailing Address - Fax:
Practice Address - Street 1:11754 GIOVANNI LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1535
Practice Address - Country:US
Practice Address - Phone:281-901-0044
Practice Address - Fax:281-572-8631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1811534902OtherNPPES(NPI)