# ACTIVE MINDS RX PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073207809
- **Authorized official:** EDWARD JOHN KAZMIR NP (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (713) 816-5646

## Contact information

- **Practice address:** 210 E LIVE OAK ST, HUNGERFORD, TX 77448-0135
- **Practice address phone:** (713) 816-5646
- **Mailing address:** PO BOX 511, HUNGERFORD, TX 77448-0511
- **Mailing address phone:** (713) 816-5646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2023
- **Last updated:** 06/05/2023