| Fresh Therapeutic Solutions Pllc | |
|
11042 Stone Legend Dr Tomball TX 77375-6472 | |
| (832) 299-4352 | |
| Not Available |
| Full Name | Fresh Therapeutic Solutions Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11042 Stone Legend Dr, Tomball, Texas |
| Authorized Official Name and Position | Sarah Ilesanmi (PMHNP) |
| Authorized Official Contact | 8322994352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Therapeutic Solutions Pllc 27708 Tomball Pkwy Ste 247 Tomball TX 77375-6472 Ph: () - | Fresh Therapeutic Solutions Pllc 11042 Stone Legend Dr Tomball TX 77375-6472 Ph: (832) 299-4352 |
| NPI Number | 1699486746 |
|---|---|
| Provider Enumeration Date | 12/09/2022 |
| Last Update Date | 01/12/2023 |
| Certification Date | 01/12/2023 |
| Medicare PECOS PAC ID | 8123488111 |
|---|---|
| Medicare Enrollment ID | O20230722000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699486746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sarah Ilesanmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083341705 PECOS PAC ID: 5193191351 Enrollment ID: I20221013001951 |
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