| NPI | 1972969491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN L. HOUSEWORTH Chief Regulatory Officer 832-248-4636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-03-16 |