Organization
ANDERKEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TULA DESHA JEFFERSON PMHNP-BC (DNP)
(832) 328-5460
Entity
Organization
Contact information
Practice address
14823 WINSTON FALLS LN, HUMBLE, TX 77396-6073
(832) 982-6708
Mailing address
14823 WINSTON FALLS LN, HUMBLE, TX 77396-6073
(832) 982-6708
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/04/2024
Last updated
07/12/2024
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