Provider Demographics
NPI:1124340799
Name:SIX PINES CLINIC, PLLC
Entity type:Organization
Organization Name:SIX PINES CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-484-5105
Mailing Address - Street 1:7324 SW FWY STE 640
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2039
Mailing Address - Country:US
Mailing Address - Phone:713-484-5105
Mailing Address - Fax:713-988-9550
Practice Address - Street 1:8850 SIX PINES DR STE 240
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2608
Practice Address - Country:US
Practice Address - Phone:281-419-8888
Practice Address - Fax:866-577-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty