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General NPI Number Information
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NPI Number | 1407193360
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Entity Type | Organization
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Legal Business Name | ALCOHOL & OTHER DRUGS RESOURCE, PLLC
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Dates
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Enumeration Date | 01/12/2013
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Last Update Date | 01/12/2013
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Provider Practice Location Address
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Address Line | 17629 EL CAMINO REAL STE. 115
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City | HOUSTON
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State | TX
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Zip | 77058-2901
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Country | US
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Telephone | 281-971-1969
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Fax | 281-249-5009
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Provider Business Mailing Address
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Address Line | 17629 EL CAMINO REAL STE. 115
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City | HOUSTON
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State | TX
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Zip | 77058-2901
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Country | US
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Telephone | 281-971-1969
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Fax | 281-249-5009
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Authorized Official
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Title or Position | PARTNER
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Name | TAMMY SAMOUR
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Credential | MS, LPC, LCDC, SAP
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Telephone | 281-326-7946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 3588
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License Number State | TX
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