MEDICARE: AMANY ABOUBAKR KHALIL LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	78811	TX

General Provider Information

NPI Number	:	1063296010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANY ABOUBAKR KHALIL LPC

Provider Business Mailing Address
First Line	:	4207 NOBLE OAK TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3260
Country	:	US
Telephone Number	:	713-598-1326
Fax Number	:

Provider Business Practice Location Address
First Line	:	4207 NOBLE OAK TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3260
Country	:	US
Telephone Number	:	713-598-1326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	08/22/2023

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