ACTIVE KETAMINE PLLC NPI 1073259156

NPI Information

ACTIVE KETAMINE, PLLC is a pain medicine psychiatry neurology in Houston, TX. The provider is 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. ACTIVE KETAMINE, PLLC NPI is 1073259156. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12250 QUEENSTON BLVD STE E
HOUSTON, TX
ZIP 77095-343
Phone: (281) 201-4511

The provider's authorized official is Jared Heathman .
The authorized official title is Managing Member and has the following contact phone number (281) 201-4511.

The enumeration date for this NPI number is 5/11/2022 and was last updated on 5/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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