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General NPI Number Information
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NPI Number | 1770815649
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Entity Type | Organization
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Legal Business Name | SPOUDAZO RESOURCES OF SOUTH TEXAS
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 5656 S STAPLES ST STE 330
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4693
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Country | US
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Telephone | 361-906-0676
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Fax | 361-906-0371
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Provider Business Mailing Address
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Address Line | 5656 S STAPLES ST STE 330
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4693
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Country | US
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Telephone | 361-906-0676
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Fax | 361-906-0371
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD L ALFORD
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Credential | MS,LPC
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Telephone | 361-906-0676
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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 | 18362
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 18362
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License Number State | TX
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