Individual
STACY SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
7601 FANNIN ST, HOUSTON, TX 77054-1905
(713) 715-4297
Mailing address
4413 BORA BORA LN, HOUSTON, TX 77045-1735
(832) 290-8518
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1182151
TX
Other
Enumeration date
01/06/2025
Last updated
06/04/2025
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