Healthcare Provider Details
I. General information
NPI: 1669771804
Provider Name (Legal Business Name): MARION PHOUMMARATH ZAHN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/25/2011
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24044 CINCO VILLAGE CENTER BLVD SUITE 100
KATY TX
77494-8432
US
IV. Provider business mailing address
24044 CINCO VILLAGE CENTER BLVD SUITE 100
KATY TX
77494-8432
US
V. Phone/Fax
- Phone: 713-975-1222
- Fax: 888-975-1526
- Phone: 713-975-1222
- Fax: 888-975-1526
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 7661 |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 34861 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: