Healthcare Provider Details

I. General information

NPI: 1932590643
Provider Name (Legal Business Name): LILIAN KUGLER L.C.D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6699 PORTWEST DR STE 150
HOUSTON TX
77024-8078
US

IV. Provider business mailing address

6699 PORTWEST DR STE 150
HOUSTON TX
77024-8078
US

V. Phone/Fax

Practice location:
  • Phone: 713-459-7188
  • Fax:
Mailing address:
  • Phone: 713-459-7188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: