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NPI Code Detail

MEDICARE: DR. REGINA LEDERMAN RN, BSN, MA, PHD

MEDICARE: DR. REGINA LEDERMAN RN, BSN, MA, PHD
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
1101YP2500XProfessional Counselor18999TX
2106H00000XMarriage & Family Therapist4963TX

General Provider Information

NPI Number : 1528204245
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REGINA LEDERMAN RN, BSN, MA, PHD
Provider Business Mailing Address
First Line : 3607 GRAMERCY ST
Second Line :
City : HOUSTON
State : TX
Zip : 77025-1320
Country : US
Telephone Number : 713-666-0172
Fax Number : 713-526-4342
Provider Business Practice Location Address
First Line : 2524 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-666-0172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2008
Last Update Date : 12/30/2008

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