Provider Demographics
NPI:1699502088
Name:FIDELITY HEALTH AND PSYCHIATRY SERVICES PLLC
Entity type:Organization
Organization Name:FIDELITY HEALTH AND PSYCHIATRY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FIDELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASANTE-ANSONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-378-4892
Mailing Address - Street 1:1251 PIN OAK RD STE 131
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7047
Mailing Address - Country:US
Mailing Address - Phone:281-378-4892
Mailing Address - Fax:
Practice Address - Street 1:27922 COLONIAL POINT DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3712
Practice Address - Country:US
Practice Address - Phone:281-378-4892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty