| Puissant Llc Dba Integrated Minds | |
|
4107 Crosspoint Blvd Suite A Edinburg TX 78539 | |
| (956) 329-7764 | |
| (956) 329-7766 |
| Full Name | Puissant Llc Dba Integrated Minds |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4107 Crosspoint Blvd, Edinburg, Texas |
| Authorized Official Name and Position | Yemi Adebowale (OFFICER/MEMBER) |
| Authorized Official Contact | 8324193267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Puissant Llc Dba Integrated Minds 4107 Crosspoint Blvd Suite A Edinburg TX 78539 Ph: (956) 329-7764 | Puissant Llc Dba Integrated Minds 4107 Crosspoint Blvd Suite A Edinburg TX 78539 Ph: (956) 329-7764 |
| NPI Number | 1154744266 |
|---|---|
| Provider Enumeration Date | 01/24/2014 |
| Last Update Date | 03/06/2017 |
| Medicare PECOS PAC ID | 4789814468 |
|---|---|
| Medicare Enrollment ID | O20140225000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154744266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 770332 (Texas) | Primary |
| Provider Name | Yemi Adebowale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053659987 PECOS PAC ID: 7416187380 Enrollment ID: I20140221000184 |
| Provider Name | Olaide Akinyinka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932637097 PECOS PAC ID: 6103172986 Enrollment ID: I20180710000137 |
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