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NPI Code Detail

MEDICARE: HOUSTON GALVESTON INSTITUTE

MEDICARE: HOUSTON GALVESTON INSTITUTE
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HOUST-0005OTHERTXCOMPCARE GROUP NUMBER
210005289OTHERTXAMERIGROUP PIN #

General Provider Information

NPI Number : 1548383045
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSTON GALVESTON INSTITUTE
Provider Business Mailing Address
First Line : 3316 MOUNT VERNON ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-3829
Country : US
Telephone Number : 713-526-8390
Fax Number : 713-528-2618
Provider Business Practice Location Address
First Line : 3316 MOUNT VERNON ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-3829
Country : US
Telephone Number : 713-526-8390
Fax Number : 713-528-2618
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SUE LEVIN
Credential :
Telephone Number : 713-526-8390
Provider Enumeration Date : 04/09/2007
Last Update Date : 08/22/2020

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Directions to “HOUSTON GALVESTON INSTITUTE ” Practice Location

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