Healthcare Provider Details

I. General information

NPI: 1265665715
Provider Name (Legal Business Name): ABIDING CHRISTIAN THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12655 WOODFOREST BLVD STE 110
HOUSTON TX
77015-3575
US

IV. Provider business mailing address

12655 WOODFOREST BLVD STE 110
HOUSTON TX
77015-3575
US

V. Phone/Fax

Practice location:
  • Phone: 713-453-2300
  • Fax: 713-453-2300
Mailing address:
  • Phone: 713-453-2300
  • Fax: 713-453-2300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: PENNY LEZAK
Title or Position: OWNER, PENNY LEZAK
Credential:
Phone: 713-453-2300