1417824236 NPI number — GLADMIND WELLNESS PLLC

Table of content: DR. SUMMER RAE SCOTT PSY.D. (NPI 1023410156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417824236 NPI number — GLADMIND WELLNESS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GLADMIND WELLNESS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417824236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9894 BISSONNET ST STE 100U
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77036-8229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-667-4998
Provider Business Mailing Address Fax Number:
281-971-0056

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9894 BISSONNET ST STE 100U
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-8229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-667-4998
Provider Business Practice Location Address Fax Number:
281-971-0056
Provider Enumeration Date:
10/17/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EZEM
Authorized Official First Name:
GLADYS
Authorized Official Middle Name:
CHIDIEBERE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
832-762-7348

Provider Taxonomy Codes

  • Taxonomy code: 364SP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)