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General NPI Number Information
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NPI Number | 1639668940
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Entity Type | Individual
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Provider Name | IRIS BILAN
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Gender | Female
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 9112 SPRING BRANCH DR
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City | HOUSTON
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State | TX
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Zip | 77080-7454
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Country | US
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Telephone | 133-596-4687
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Fax |
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Provider Business Mailing Address
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Address Line | 9002 PITNER RD
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City | HOUSTON
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State | TX
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Zip | 77080-1745
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Country | US
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Telephone | 713-359-6468
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 79566
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License Number State | TX
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