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General NPI Number Information
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NPI Number | 1710342258
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Entity Type | Organization
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Legal Business Name | TMHO LLC TEXASMENTALHEALTHONLINE
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 4812 MAPLEWOOD AVE # 76308
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City | WICHITA FALLS
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State | TX
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Zip | 76308-5312
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Country | US
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Telephone | 940-432-8631
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Fax |
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Provider Business Mailing Address
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Address Line | 4812 MAPLEWOOD AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76308-5312
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Country | US
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Telephone | 940-432-8631
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Fax |
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Authorized Official
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Title or Position | CEO/SOLE OWNER
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Name | MR. MARTIN K SHAW
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Credential | LPC, LMFT
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Telephone | 940-733-1825
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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 |
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License Number State |
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