Healthcare Provider Details

I. General information

NPI: 1821186644
Provider Name (Legal Business Name): GEORGE A. VROULIS PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 BLALOCK RD STE 200
HOUSTON TX
77055-6456
US

IV. Provider business mailing address

1220 BLALOCK RD STE 200
HOUSTON TX
77055-6456
US

V. Phone/Fax

Practice location:
  • Phone: 713-447-8977
  • Fax:
Mailing address:
  • Phone: 713-447-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number21869
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: