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General NPI Number Information
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NPI Number | 1851783534
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Entity Type | Organization
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Legal Business Name | IDOC TELEHEALTH SOLUTIONS, INC
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 2311 W MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77098-3218
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Country | US
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Telephone | 303-922-4636
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Fax | 303-648-4534
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Provider Business Mailing Address
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Address Line | 4635 SOUTHWEST FWY STE 525
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City | HOUSTON
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State | TX
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Zip | 77027-7157
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Country | US
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Telephone | 713-234-4431
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Fax | 877-712-5707
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | EVETTE LEWIS
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Credential |
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Telephone | 503-421-5124
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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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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 254411
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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