MEDICARE: LIGHTHOUSE FOR THE BLIND OF HOUSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	152WL0500X	Low Vision Rehabilitation Optometrist
3	2084P0800X	Psychiatry Physician
4	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000329100	OTHER	TX	DAHS
2	000321000	OTHER	TX	DAHS
3	001000741	OTHER	TX	DB WAIVER

General Provider Information

NPI Number	:	1588878870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTHOUSE FOR THE BLIND OF HOUSTON

Provider Business Mailing Address
First Line	:	3602 W DALLAS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1704
Country	:	US
Telephone Number	:	713-284-8494
Fax Number	:	713-284-8468

Provider Business Practice Location Address
First Line	:	3602 W DALLAS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1704
Country	:	US
Telephone Number	:	713-284-8494
Fax Number	:	713-284-8468

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GIBSON DUTERROIL
Credential	:
Telephone Number	:	713-284-8420

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	01/28/2025

Similar Medicare Providers

1497716773 — JENNIFER WICKESBERG AU.D.
Practice Location Address:

3636 W DALLAS ST
HOUSTON, TX
77019-1704

Practice Phone: 713-523-4722
Practice Fax: 713-523-8399

1134130974 — MELINDA B BENJUMEA LPC, LPA
Practice Location Address:

3602 W DALLAS ST
HOUSTON, TX
77019-1704

Practice Phone: 713-284-8440
Practice Fax: 713-284-8440

1790890283 — MELISSA ANN BECK M.A., CCC-A
Practice Location Address:

3636 W DALLAS ST
HOUSTON, TX
77019-1704

Practice Phone: 713-523-3633
Practice Fax: 713-523-8399

1649357922 — SHELLEY MARIE MATHAY
Practice Location Address:

3636 W DALLAS ST
HOUSTON, TX
77019-1704

Practice Phone: 713-523-3633
Practice Fax:

1366659534 — CELESTE EVE JOHNSON LPC
Practice Location Address:

3630 W DALLAS ST
HOUSTON, TX
77019-1704

Practice Phone: 713-970-4450
Practice Fax:

1952501140 — THE LIGHTHOUSE OF HOUSTON
Practice Location Address:

3602 W DALLAS ST
HOUSTON, TX
77019-1704

Practice Phone: 713-527-9561
Practice Fax:

Directions to “LIGHTHOUSE FOR THE BLIND OF HOUSTON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.