| Complete Serenity Llc | |
|
2006 Broadway St Ste 101 Pearland TX 77581-5559 | |
| (832) 779-8521 | |
| Not Available |
| Full Name | Complete Serenity Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2006 Broadway St Ste 101, Pearland, Texas |
| Authorized Official Name and Position | Aisha Harris (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7139701093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Serenity Llc 2906 Concord Knoll Dr Pearland TX 77581-4791 Ph: (832) 779-8521 | Complete Serenity Llc 2006 Broadway St Ste 101 Pearland TX 77581-5559 Ph: (832) 779-8521 |
| NPI Number | 1629553698 |
|---|---|
| Provider Enumeration Date | 09/26/2018 |
| Last Update Date | 08/31/2020 |
| Certification Date | 08/31/2020 |
| Medicare PECOS PAC ID | 4385061472 |
|---|---|
| Medicare Enrollment ID | O20200903002481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629553698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelly M Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114427309 PECOS PAC ID: 3577808583 Enrollment ID: I20181219003035 |
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