Organization
PHOENIX MINDCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAANAN BLAKEMORE (OWNER)
(737) 230-0237
Entity
Organization
Contact information
Practice address
701 FM 685 STE 530, PFLUGERVILLE, TX 78660-7105
(737) 230-0237
Mailing address
20501 ROLLING CREEK RD, PFLUGERVILLE, TX 78660-6023
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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