Healthcare Provider Details

I. General information

NPI: 1740423540
Provider Name (Legal Business Name): THEOPHILUS A NATTER PSYCHOTHERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N SAM HOUSTON PKWY E STE B285
HOUSTON TX
77060-3315
US

IV. Provider business mailing address

350 N SAM HOUSTON PKWY E STE B285
HOUSTON TX
77060-3315
US

V. Phone/Fax

Practice location:
  • Phone: 281-809-5069
  • Fax: 832-328-8715
Mailing address:
  • Phone: 281-809-5069
  • Fax: 832-328-8715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number3031
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3031
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3031
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4770
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3031
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number3031
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3031
License Number StateTX
# 8
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: