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NPI Code Detail

MEDICARE: MR. BRECARIO KIANTE' OGDEN LPC-A

MEDICARE: MR. BRECARIO KIANTE' OGDEN LPC-A
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
1101YM0800XMental Health Counselor101291TX

General Provider Information

NPI Number : 1457210932
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRECARIO KIANTE' OGDEN LPC-A
Provider Business Mailing Address
First Line : 1555 CULLEN BLVD APT 1514
Second Line :
City : PEARLAND
State : TX
Zip : 77581-5071
Country : US
Telephone Number : 469-515-6677
Fax Number :
Provider Business Practice Location Address
First Line : 16225 PARK TEN PL STE 500
Second Line :
City : HOUSTON
State : TX
Zip : 77084-5152
Country : US
Telephone Number : 469-515-6677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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