Healthcare Provider Details

I. General information

NPI: 1679619597
Provider Name (Legal Business Name): HOLLY HUSTON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 WESLAYAN SUITE 305
HOUSTON TX
77027-5753
US

IV. Provider business mailing address

3000 WESLAYAN SUITE 305
HOUSTON TX
77027-5753
US

V. Phone/Fax

Practice location:
  • Phone: 713-623-6263
  • Fax: 713-623-4243
Mailing address:
  • Phone: 713-623-6263
  • Fax: 713-623-4243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number15394
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number15394
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: