Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP143243 | TX |
NPI | 1003463506 |
---|---|
Provider Name | Mehreen Ghanchi |
First Address | Friendswood, TX 77546-4682 |
Second Address | Friendswood, TX 77546-3989 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2019 |
Last Update Date | 17/02/2020 |