Healthcare Provider Details

I. General information

NPI: 1831204148
Provider Name (Legal Business Name): THE CENTER FOR PERSONAL AND FAMILY GROWTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 SPACE PARK DR STE D
HOUSTON TX
77058-3469
US

IV. Provider business mailing address

1345 SPACE PARK DR STE D
HOUSTON TX
77058-3469
US

V. Phone/Fax

Practice location:
  • Phone: 281-333-3246
  • Fax: 281-333-0221
Mailing address:
  • Phone: 281-333-3246
  • Fax: 281-333-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9930
License Number StateTX

VIII. Authorized Official

Name: MR. GEORGE RANDALL BRAZZEL
Title or Position: OWNER
Credential: MA, LPC, LMFT
Phone: 281-333-3246