Provider Demographics
NPI:1861127193
Name:METAPSYCH, PLLC
Entity type:Organization
Organization Name:METAPSYCH, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JEJELOWO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:832-463-1933
Mailing Address - Street 1:5959 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7622
Mailing Address - Country:US
Mailing Address - Phone:832-463-1933
Mailing Address - Fax:
Practice Address - Street 1:5959 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7622
Practice Address - Country:US
Practice Address - Phone:832-463-1933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)