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NPI Code Detail

MEDICARE: HOLLY CONEWAY LPC

MEDICARE: HOLLY CONEWAY 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
1101Y00000XCounselor74914TX

General Provider Information

NPI Number : 1114418043
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY CONEWAY LPC
Provider Business Mailing Address
First Line : 1502 SAWYER ST STE 234
Second Line :
City : HOUSTON
State : TX
Zip : 77007-4446
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1502 SAWYER ST STE 234
Second Line :
City : HOUSTON
State : TX
Zip : 77007-4446
Country : US
Telephone Number : 281-783-9297
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2018
Last Update Date : 05/26/2018

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Directions to “ HOLLY CONEWAY LPC” Practice Location

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