MEDICARE: JACQUIE YOUTH FOUNDATION

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	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1750593521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACQUIE YOUTH FOUNDATION

Provider Business Mailing Address
First Line	:	1506 W ALABAMA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4106
Country	:	US
Telephone Number	:	713-523-0122
Fax Number	:	713-523-1512

Provider Business Practice Location Address
First Line	:	1506 W ALABAMA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4106
Country	:	US
Telephone Number	:	713-523-0122
Fax Number	:	713-523-1512

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JACQUELINE PATTERSON
Credential	:
Telephone Number	:	713-523-0122

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1851446090 — DR. PATRICK JAMES MCNAMARA M.D.
Practice Location Address:

1512 W ALABAMA ST
HOUSTON, TX
77006-4106

Practice Phone: 713-524-4837
Practice Fax: 713-529-8350

1699979559 — PATRICK J. MCNAMARA, M.D., P.A.
Practice Location Address:

1512 W ALABAMA ST
HOUSTON, TX
77006-4106

Practice Phone: 713-524-4837
Practice Fax: 713-529-8350

1417941857 — DR. WILLIAM G FACH O.D.
Practice Location Address:

6127 FM 1960 RD W
HOUSTON, TX
77069-4106

Practice Phone: 281-469-2020
Practice Fax: 281-469-7531

1801017959 — DR. PHUONG-LOAN SI DONG O.D.
Practice Location Address:

6127 FM 1960 RD W STE A
HOUSTON, TX
77069-4106

Practice Phone: 281-469-2020
Practice Fax: 281-469-7531

1164682175 — MY HEALTH LAB
Practice Location Address:

4106 TIDEWATER DR
HOUSTON, TX
77045-4338

Practice Phone: 713-517-1875
Practice Fax:

1700105509 — UNIQUE ACS GROUP LLC
Practice Location Address:

4106 FANNIN ST
HOUSTON, TX
77004-4808

Practice Phone: 713-772-6060
Practice Fax: 713-526-6064

Directions to “JACQUIE YOUTH FOUNDATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.