Provider Demographics
NPI:1104643394
Name:LET TAS PSYCHIATRY SERVICES LLC
Entity type:Organization
Organization Name:LET TAS PSYCHIATRY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:281-752-6895
Mailing Address - Street 1:11301 RICHMOND AVE STE K109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5549
Mailing Address - Country:US
Mailing Address - Phone:281-752-6895
Mailing Address - Fax:
Practice Address - Street 1:11301 RICHMOND AVE STE K109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5549
Practice Address - Country:US
Practice Address - Phone:817-526-8952
Practice Address - Fax:281-845-7782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty