Provider Demographics
NPI:1063279222
Name:BIMENYIMANA, PIE (PMHNP)
Entity type:Individual
Prefix:
First Name:PIE
Middle Name:
Last Name:BIMENYIMANA
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 SLEEPY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-7616
Mailing Address - Country:US
Mailing Address - Phone:817-770-6612
Mailing Address - Fax:
Practice Address - Street 1:5712 SLEEPY CREEK LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-7616
Practice Address - Country:US
Practice Address - Phone:817-770-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11276452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry