Basic Information
Provider Information
NPI: 1639799067
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DURBIN-GARFIELD
FirstName: ANGELA
MiddleName: KOLLENE
NamePrefix: MRS.
NameSuffix:  
Credential: APRN, PMHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2915 S CEDAR HOLLOW DR
Address2:  
City: PEARLAND
State: TX
PostalCode: 775848155
CountryCode: US
TelephoneNumber: 8326055057
FaxNumber:  
Practice Location
Address1: 1941 EAST RD
Address2:  
City: HOUSTON
State: TX
PostalCode: 770546010
CountryCode: US
TelephoneNumber: 7134862700
FaxNumber: 7134862553
Other Information
ProviderEnumerationDate: 04/27/2020
LastUpdateDate: 04/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XAP145835TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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