Healthcare Provider Details

I. General information

NPI: 1194763599
Provider Name (Legal Business Name): DOREEN KOTIK-HARPER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DOREEN KOTIK-HARPER PHD

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14023 SOUTHWEST FWY
SUGAR LAND TX
77478-3550
US

IV. Provider business mailing address

3400 BISSONNET ST SUITE 270
HOUSTON TX
77005-2155
US

V. Phone/Fax

Practice location:
  • Phone: 281-325-4267
  • Fax: 281-325-4262
Mailing address:
  • Phone: 713-594-0744
  • Fax: 713-668-6595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23255
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: