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4103 S Main St Ste 120 Stafford TX 77477-5305 | |
| (724) 599-5901 | |
| (877) 774-5688 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4103 S Main St Ste 120, Stafford, Texas |
| Authorized Official Name and Position | Sarah Gatumu (OWNER) |
| Authorized Official Contact | 7245995901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4103 S Main St Ste 120 Stafford TX 77477-5305 Ph: (724) 599-5901 | 4103 S Main St Ste 120 Stafford TX 77477-5305 Ph: (724) 599-5901 |
| NPI Number | 1689268500 |
|---|---|
| Provider Enumeration Date | 02/22/2021 |
| Last Update Date | 07/06/2021 |
| Certification Date | 07/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689268500 | NPI | - | NPPES |
| 1750489845 | Medicaid | PA |
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