MEDICARE: TEXAS GROVE RECOVERY LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1376495432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS GROVE RECOVERY LLC

Provider Business Mailing Address
First Line	:	414 W HOUSE ST
Second Line	:
City	:	ALVIN
State	:	TX
Zip	:	77511-2817
Country	:	US
Telephone Number	:	281-409-0937
Fax Number	:	281-409-0937

Provider Business Practice Location Address
First Line	:	414 W HOUSE ST
Second Line	:
City	:	ALVIN
State	:	TX
Zip	:	77511-2817
Country	:	US
Telephone Number	:	281-409-0937
Fax Number	:	281-409-0937

Authorized Official
Title or Position	:	CEO
Name	:	PAUL DYNE
Credential	:	DYNE
Telephone Number	:	281-409-0937

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “TEXAS GROVE RECOVERY LLC ” Practice Location

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