Healthcare Provider Details

I. General information

NPI: 1144063587
Provider Name (Legal Business Name): RICARDO NOEL MEJIAS GONZALEZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 W ALABAMA ST APT 9302
HOUSTON TX
77027-5242
US

IV. Provider business mailing address

3805 W ALABAMA ST APT 9302
HOUSTON TX
77027-5242
US

V. Phone/Fax

Practice location:
  • Phone: 787-213-7868
  • Fax:
Mailing address:
  • Phone: 787-213-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104365
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: