Healthcare Provider Details

I. General information

NPI: 1437169349
Provider Name (Legal Business Name): MICHAEL THADDEUS YEAGER LCDC, CAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 12/14/2025
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 KATY FREEWAY SUITE 428
HOUSTON TX
77024
US

IV. Provider business mailing address

9525 KATY FREEWAY SUITE 428
HOUSTON TX
77024
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-3279
  • Fax: 713-461-9329
Mailing address:
  • Phone: 713-461-3279
  • Fax: 713-461-9329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number371
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAD00126
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: