ACTIVE KETAMINE, PLLC – NPI #1073259156
Psychiatry & Neurology

A neurologist, child neurologists or psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Health Care Provider Taxonomy Code for Psychiatry & Neurology

ACTIVE KETAMINE, PLLC is a psychiatry & neurologist located in HOUSTON, TX. NPPES has assigned the NPI number 1073259156 to ACTIVE KETAMINE, PLLC on May 11, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2084P2900X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Pain Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ACTIVE KETAMINE, PLLC below.

NPI Profile for
ACTIVE KETAMINE, PLLC

NPI Number
1073259156
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ACTIVE KETAMINE, PLLC
Primary location
12250 QUEENSTON BLVD STE E
HOUSTON, TX 77095-5343
Phone: (281) 201-4511 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JARED HEATHMAN
MANAGING MEMBER
Phone: (281) 201-4511
Updated
Certification Date
May 11, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084P2900X
- Psychiatry & Neurology / Pain Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
www.ActiveKetamine.com
Endpoint type
CONNECT URL
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
12250 QUEENSTON BLVD STE E,
HOUSTON, TX 77025-1669