=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386982031
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBRA LYNN GRAMMAS PH.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2013
-----------------------------------------------------
Last Update Date | 04/21/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6300 WEST LOOP S SUITE 390
-----------------------------------------------------
City | BELLAIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77401-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-304-6554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2105 BROOK HAVEN DR
-----------------------------------------------------
City | LEAGUE CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77573-4474
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-304-6554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number | 34464
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------