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General NPI Number Information
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NPI Number | 1407056690
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Entity Type | Organization
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Legal Business Name | THE LIGHTHOUSE OF HOUSTON
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 3602 W DALLAS ST
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City | HOUSTON
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State | TX
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Zip | 77019-1704
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Country | US
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Telephone | 713-527-9561
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Fax |
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Provider Business Mailing Address
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Address Line | 3602 W DALLAS ST
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City | HOUSTON
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State | TX
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Zip | 77019-1704
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Country | US
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Telephone | 713-527-9561
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Fax |
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Authorized Official
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Title or Position | VP/CHIEF OPERATIONAL OFFICER
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Name | SHELAGH K MORAN
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Credential |
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Telephone | 713-284-8490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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