| NPI | 1588760839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY P BEVAN President 281-242-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 23738) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 23543) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2012-10-18 |