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General NPI Number Information
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NPI Number | 1902076177
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Entity Type | Organization
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Legal Business Name | ATCG LLC
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 530 N SAM HOUSTON PKWY E STE 202
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City | HOUSTON
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State | TX
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Zip | 77060-4026
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Country | US
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Telephone | 281-260-0821
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Fax | 281-260-0352
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Provider Business Mailing Address
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Address Line | PO BOX 14673
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City | HUMBLE
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State | TX
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Zip | 77347-4673
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Country | US
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Telephone | 281-260-0821
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Fax | 281-260-0352
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. REX A KING
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Credential |
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Telephone | 281-260-0821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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