Provider Demographics
NPI:1992175186
Name:OJEDA PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:OJEDA PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LIZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:OJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:979-820-7024
Mailing Address - Street 1:535 E FERNHURST DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:535 E FERNHURST DR
Practice Address - Street 2:SUITE 107
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1431
Practice Address - Country:US
Practice Address - Phone:979-820-7024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36264103T00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty