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General NPI Number Information
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NPI Number | 1740302512
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Entity Type | Organization
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Legal Business Name | EAGLE PAIN & STRESS CLINIC, INC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4542 NASSAU DR
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City | SUGAR LAND
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State | TX
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Zip | 77479-2115
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Country | US
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Telephone | 832-794-1621
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Fax | 281-565-1853
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Provider Business Mailing Address
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Address Line | 4542 NASSAU DR
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City | SUGAR LAND
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State | TX
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Zip | 77479-2115
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Country | US
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Telephone | 832-794-1621
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Fax | 281-565-1853
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CARLA L HARDY
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Credential | LMFT, LPC
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Telephone | 832-794-1621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1841
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6082
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License Number State | TX
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