Provider Demographics
NPI:1487330478
Name:KUBARA PSYCHIATRY & BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:KUBARA PSYCHIATRY & BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:U
Authorized Official - Last Name:RAGSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:346-538-0968
Mailing Address - Street 1:9894 BISSONNET ST STE 788
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8272
Mailing Address - Country:US
Mailing Address - Phone:346-538-0968
Mailing Address - Fax:
Practice Address - Street 1:9894 BISSONNET ST STE 788
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8272
Practice Address - Country:US
Practice Address - Phone:346-538-0968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health