ACTIVE KETAMINE, PLLC
NPI 1073259156
Psychiatry & Neurology - Pain Medicine in Houston, TX

Q: What is Active Ketamine, PLLC's NPI number?

The NPI number for Active Ketamine, PLLC is 1073259156. It was assigned to this organization in the NPPES registry on May 11, 2022.

Q: What is Active Ketamine, PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Pain Medicine, with taxonomy code 2084P2900X.

Active since May 11, 2022

12250 QUEENSTON BLVD STE E, HOUSTON, TX 77095(281) 201-4511 Get Directions Write a Review

NPPES record last updated: May 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Active Ketamine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACTIVE KETAMINE, PLLC (NPI 1073259156) is a healthcare organization registered as a pain medicine in Houston, Texas and active in the NPI registry since May 2022. The organization lists Jared Heathman, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1073259156

Entity TypeOrganization

Primary Taxonomy2084P2900X

Legal Business NameACTIVE KETAMINE, PLLC

Location Address12250 QUEENSTON BLVD STE EHouston, TX 77095-5343

Mailing Address12250 Queenston Blvd Ste EHouston, TX 77095-5343

Phone(281) 201-4511

Organization SubpartNo

Authorized OfficialJared HeathmanManaging Member · (281) 201-4511

Enumeration DateMay 11, 2022

NPPES CertifiedMay 11, 2022

✔ NPI 1073259156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2084P2900X

Definition

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.

12250 QUEENSTON BLVD STE E, Houston, TX 77095

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YOUR FAMILY PSYCHIATRIST, PLLC

Clinic/Center (Mental Health (Including Community Mental Health Center))

12250 QUEENSTON BLVD STE E
HOUSTON, TX 77095

Harris County (281) 849-4080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Active Ketamine, PLLC's NPI number?

The NPI number for Active Ketamine, PLLC is 1073259156. It was assigned to this organization in the NPPES registry on May 11, 2022.

Where is Active Ketamine, PLLC located?

Active Ketamine, PLLC is located at 12250 Queenston Blvd Ste E, Houston, TX 77095. The listed phone number is (281) 201-4511.

What is Active Ketamine, PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Pain Medicine, with taxonomy code 2084P2900X.

When was this NPI record last updated?

The NPPES record for Active Ketamine, PLLC was last updated on May 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.