MEDICARE: DEBRA J BROD LCSW

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	1041C0700X	Clinical Social Worker	51023	TX

General Provider Information

NPI Number	:	1114292836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA J BROD LCSW

Provider Business Mailing Address
First Line	:	2525 ROBINHOOD ST
Second Line	:	SUITE 109
City	:	HOUSTON
State	:	TX
Zip	:	77005-2573
Country	:	US
Telephone Number	:	713-705-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	7413 BROMPTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-2202
Country	:	US
Telephone Number	:	713-705-6262
Fax Number	:

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

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	01/14/2016

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