Organization
FAMILY PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN BURKET (MANAGER)
(281) 400-3301
Entity
Organization
Contact information
Practice address
341 E PARKWOOD AVE, FRIENDSWOOD, TX 77546-5147
(281) 400-3301
(281) 400-3307
Mailing address
PO BOX 1808, FRIENDSWOOD, TX 77549-1808
(281) 400-3301
(281) 400-3307
Taxonomy
Speciality
Code
Description
License number
State
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
H2742
TX
2084P0800X
Psychiatry Physician
Primary
H2742
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098513703
—
TX
Enumeration date
10/09/2008
Last updated
06/26/2009
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