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2527 Chestnut Ridge Dr Kingwood TX 77339-3031 | |
| (281) 358-4747 | |
| (281) 358-2213 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2527 Chestnut Ridge Dr, Kingwood, Texas |
| Authorized Official Name and Position | Pradeep K Roy (PRESIDENT) |
| Authorized Official Contact | 2813584747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 6663 Kingwood TX 77325-6663 Ph: (281) 358-4747 | 2527 Chestnut Ridge Dr Kingwood TX 77339-3031 Ph: (281) 358-4747 |
| NPI Number | 1982899100 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 06/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982899100 | NPI | - | NPPES |
| 19828991-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | H3160 (Texas) | Primary |
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