MEDICARE: MRS. ANA MARIA R DE PAIVA LCSW ACP BCD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	16760	TX

General Provider Information

NPI Number	:	1174684823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANA MARIA R DE PAIVA LCSW ACP BCD

Provider Business Mailing Address
First Line	:	1215 BARKDULL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-6403
Country	:	US
Telephone Number	:	713-659-4242
Fax Number	:	713-523-8111

Provider Business Practice Location Address
First Line	:	1215 BARKDULL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-6403
Country	:	US
Telephone Number	:	713-659-4242
Fax Number	:	713-523-8111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	10/19/2010

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