Healthcare Provider Details

I. General information

NPI: 1376788596
Provider Name (Legal Business Name): DAVID A. HOOTEN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6502 SLIDE RD SUITE #207
LUBBOCK TX
79424-1329
US

IV. Provider business mailing address

6502 SLIDE RD SUITE #207
LUBBOCK TX
79424-1329
US

V. Phone/Fax

Practice location:
  • Phone: 806-771-8808
  • Fax: 806-771-8809
Mailing address:
  • Phone: 806-771-8808
  • Fax: 806-771-8809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3009
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11132
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: