Individual
MYISHA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
633 E FERNHURST DR STE 304, KATY, TX 77450-1586
(346) 361-0010
Mailing address
633 E FERNHURST DR STE 304, KATY, TX 77450-1586
(346) 361-0010
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
25213697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2547555
NONE
TX
Enumeration date
03/01/2022
Last updated
03/01/2022
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