=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013518273
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL MURRY WORKMAN LMSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2020
-----------------------------------------------------
Last Update Date | 11/04/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4646 WILD INDIGO ST STE 150
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77027-7190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-701-9362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 516 HIGHLAND ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77009-6627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-412-1538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 69387
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------