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General NPI Number Information
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NPI Number | 1548483365
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Entity Type | Individual
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Provider Name | VATSALA MADHAV KOORSE L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10101 SOUTHWEST FREEWAY, SUITE 310
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City | HOUSTON
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State | TX
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Zip | 77074
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Country | US
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Telephone | 832-217-9455
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Fax |
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Provider Business Mailing Address
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Address Line | 4507 MEADOW GREEN DRIVE
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City | SUGAR LAND
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State | TX
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Zip | 77479-3216
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Country | US
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Telephone | 281-265-8079
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19319
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License Number State | TX
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