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General NPI Number Information
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NPI Number | 1528405347
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Entity Type | Individual
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Provider Name | BRANDI LACE HISCOX LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 17510 HUFFMEISTER RD SUITE 103 & 105
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City | CYPRESS
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State | TX
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Zip | 77429-6785
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Country | US
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Telephone | 281-658-3265
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Fax | 281-373-5202
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Provider Business Mailing Address
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Address Line | 15803 CADE CT
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City | HOUSTON
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State | TX
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Zip | 77095-3753
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Country | US
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Telephone | 870-362-4033
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Fax | 281-373-5202
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 62160
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6883-C
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License Number State | AR
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