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General NPI Number Information
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NPI Number | 1770942989
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Entity Type | Organization
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Legal Business Name | FOWLER & TIDWELL COUNSELING, PLLC
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Dates
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Enumeration Date | 02/16/2016
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 7155 OLD KATY RD STE S215
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City | HOUSTON
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State | TX
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Zip | 77024-2267
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Country | US
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Telephone | 832-831-8379
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Fax |
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Provider Business Mailing Address
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Address Line | 7155 OLD KATY RD STE S215
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City | HOUSTON
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State | TX
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Zip | 77024-2267
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENAI D TIDWELL
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Credential | LPC
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Telephone | 832-831-8379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | TX
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