Organization
WAH PSYCHIATRIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA OMOLEME (CEO)
(240) 547-8312
Entity
Organization
Contact information
Practice address
11104 W AIRPORT BLVD STE 215C, STAFFORD, TX 77477-3035
(240) 547-8312
Mailing address
11104 W AIRPORT BLVD STE 215C, STAFFORD, TX 77477-3035
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
03/06/2024
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