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Active Ketamine, Pllc

Pain Medicine (Psychiatry & Neurology) Physician in Houston, TX · enumerated 2022 · authorized official Jared Heathman, Managing Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1073259156

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Registry record

Entity type Organization (Type 2)
Legal business name Active Ketamine, Pllc
Practice address 12250 Queenston Blvd Ste E, Houston, TX, 77095
Phone (281) 201-4511
Enumeration date May 11, 2022
Last updated in NPPES May 11, 2022

Taxonomy & classification

2084P2900X Pain Medicine (Psychiatry & Neurology) Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jared Heathman
Title Managing Member
Phone (281) 201-4511

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Active Ketamine, Pllc?
The NPI for Active Ketamine, Pllc is 1073259156, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Active Ketamine, Pllc?
NPPES lists Jared Heathman (Managing Member) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-05-11.