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General NPI Number Information
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NPI Number | 1013180058
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Entity Type | Organization
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Legal Business Name | TEXAS PREVENTION NETWORK INC
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 10103 FONDREN RD STE 330
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City | HOUSTON
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State | TX
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Zip | 77096-4658
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Country | US
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Telephone | 713-981-6063
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Fax | 713-981-9772
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Provider Business Mailing Address
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Address Line | 10103 FONDREN RD STE 330
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City | HOUSTON
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State | TX
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Zip | 77096-4658
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Country | US
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Telephone | 713-981-6063
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Fax | 713-981-9772
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Authorized Official
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Title or Position | CEO
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Name | ANDREW IWE
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Credential | LCDC,LMFT,SAP
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Telephone | 713-981-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2393-A
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License Number State | TX
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