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411 Park Grove Ln Ste 510 Katy TX 77450-1575 | |
| (713) 461-7878 | |
| (713) 461-7877 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 411 Park Grove Ln Ste 510, Katy, Texas |
| Authorized Official Name and Position | Brenda Perales (OFFICE MANAGER) |
| Authorized Official Contact | 7134617878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
411 Park Grove Ln Ste 510 Katy TX 77450-1575 Ph: (713) 461-7878 | 411 Park Grove Ln Ste 510 Katy TX 77450-1575 Ph: (713) 461-7878 |
| NPI Number | 1962529115 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 02/09/2016 |
| Medicare PECOS PAC ID | 1254359789 |
|---|---|
| Medicare Enrollment ID | O20051103000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962529115 | NPI | - | NPPES |
| 182267801 | Medicaid | TX | |
| 0047MY | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | K5645 (Texas) | Primary |
| Provider Name | Sevak T Ohanian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922180637 PECOS PAC ID: 2062430598 Enrollment ID: I20051103000513 |
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