| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 17810 Spring Tree, Humble, Texas |
| Authorized Official Name and Position | Florence Coaxum (OWNER) |
| Authorized Official Contact | 7137326191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17810 Spring Tree Drive Humble TX 77396 Ph: (713) 732-6791 | 17810 Spring Tree Humble TX 77396 Ph: (713) 732-6191 |
| NPI Number | 1952641235 |
|---|---|
| Provider Enumeration Date | 02/22/2013 |
| Last Update Date | 02/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952641235 | NPI | - | NPPES |
| 146611201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 23109 (Texas) | Primary |
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