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NPI Code Detail

MEDICARE: ANDREW OSHOBU LCDC

MEDICARE: ANDREW OSHOBU LCDC
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
1222Q00000XDevelopmental Therapist
2101YA0400XAddiction (Substance Use Disorder) Counselor16667TX

General Provider Information

NPI Number : 1558718825
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW OSHOBU LCDC
Provider Business Mailing Address
First Line : 7248 BRISA RD
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-0088
Country : US
Telephone Number : 281-253-9318
Fax Number :
Provider Business Practice Location Address
First Line : 5718 WESTHEIMER RD STE 1000
Second Line :
City : HOUSTON
State : TX
Zip : 77057-9903
Country : US
Telephone Number : 409-939-1030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2016
Last Update Date : 09/02/2023

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Directions to “ ANDREW OSHOBU LCDC” Practice Location

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