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General NPI Number Information
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NPI Number | 1407213028
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Entity Type | Individual
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Provider Name | GEORGE CHEUKA LCDC
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Gender | Male
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 401 W TEXAS AVE
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City | BAYTOWN
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State | TX
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Zip | 77520-4751
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Country | US
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Telephone | 281-427-4226
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Fax | 280-839-7848
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Provider Business Mailing Address
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Address Line | 401 W TEXAS AVE
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City | BAYTOWN
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State | TX
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Zip | 77520-4751
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Country | US
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Telephone | 281-427-4226
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Fax | 280-839-7848
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 7644
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License Number State | TX
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