Healthcare Provider Details

I. General information

NPI: 1922762624
Provider Name (Legal Business Name): EMILY HLADIK MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 FAIRMONT PKWY STE 200
PASADENA TX
77505-4511
US

IV. Provider business mailing address

2525 GARNETFIELD LN
FRIENDSWOOD TX
77546-4667
US

V. Phone/Fax

Practice location:
  • Phone: 281-769-2238
  • Fax:
Mailing address:
  • Phone: 405-853-5496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number202560
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: