| Preferred Behavioral Health Pllc | |
|
424 Park Grove Lane Katy TX 77450-1571 | |
| (832) 913-3765 | |
| (832) 913-6534 |
| Full Name | Preferred Behavioral Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 424 Park Grove Lane, Katy, Texas |
| Authorized Official Name and Position | Benjamin Wowo (MD/CEO) |
| Authorized Official Contact | 9174347735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Behavioral Health Pllc 3407 Grand Pebble Ln Katy TX 77494-0707 Ph: () - | Preferred Behavioral Health Pllc 424 Park Grove Lane Katy TX 77450-1571 Ph: (832) 913-3765 |
| NPI Number | 1487019816 |
|---|---|
| Provider Enumeration Date | 12/30/2015 |
| Last Update Date | 08/17/2022 |
| Certification Date | 08/17/2022 |
| Medicare PECOS PAC ID | 0143524959 |
|---|---|
| Medicare Enrollment ID | O20160215001032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487019816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | P9770 (Texas) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | P9770 (Texas) | Secondary |
| Provider Name | Benjamin E Wowo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295048528 PECOS PAC ID: 9335323807 Enrollment ID: I20140620000204 |
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