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General NPI Number Information
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NPI Number | 1255940722
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Entity Type | Organization
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Legal Business Name | LAGRUE INC.
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 888 W SAM HOUSTON PKWY S STE 280
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City | HOUSTON
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State | TX
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Zip | 77042-1991
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Country | US
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Telephone | 832-364-9413
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Fax |
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Provider Business Mailing Address
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Address Line | 14565 MISTY MEADOW LN
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City | HOUSTON
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State | TX
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Zip | 77079-3175
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Country | US
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Telephone | 832-364-9413
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Fax | 832-369-7398
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MRS. TAMRA A LAGRUE
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Credential | LCSW
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Telephone | 832-364-9413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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