MEDICARE: FAMILY INSIGHT, P.C.

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	101YM0800X	Mental Health Counselor	11332	TX

General Provider Information

NPI Number	:	1417126509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY INSIGHT, P.C.

Provider Business Mailing Address
First Line	:	14825 SAINT MARYS LN
Second Line	:	SUITE 264
City	:	HOUSTON
State	:	TX
Zip	:	77079-2904
Country	:	US
Telephone Number	:	281-596-9293
Fax Number	:	713-629-4439

Provider Business Practice Location Address
First Line	:	14825 SAINT MARYS LN
Second Line	:	SUITE 264
City	:	HOUSTON
State	:	TX
Zip	:	77079-2904
Country	:	US
Telephone Number	:	281-596-9293
Fax Number	:	713-629-4439

Authorized Official
Title or Position	:	SHAREHOLDER
Name	:	MRS. RAQUEL I. FERNANDEZ
Credential	:	LPC, LMFT, MA
Telephone Number	:	281-596-9293

Provider Enumeration Date	:	02/22/2008
Last Update Date	:	02/22/2008

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