MEDICARE: DR. IDETTE RUMANN PH.D

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	101Y00000X	Counselor	11961	TX
2	103T00000X	Psychologist	11961	TX
3	101YM0800X	Mental Health Counselor	11961	TX
4	106H00000X	Marriage & Family Therapist	11961	TX
5	101YP2500X	Professional Counselor	11961	TX

General Provider Information

NPI Number	:	1174680862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IDETTE RUMANN PH.D

Provider Business Mailing Address
First Line	:	957 NASA PKWY
Second Line	:	SUITE 193
City	:	HOUSTON
State	:	TX
Zip	:	77058-3039
Country	:	US
Telephone Number	:	281-435-4788
Fax Number	:	832-415-6403

Provider Business Practice Location Address
First Line	:	3333 BAYSHORE BLVD
Second Line	:	SUITE 350
City	:	PASADENA
State	:	TX
Zip	:	77504-1952
Country	:	US
Telephone Number	:	281-435-4788
Fax Number	:

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	01/27/2009

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