| Iconic Journey | |
|
14090 Southwest Fwy Ste 300 Sugar Land TX 77478-3679 | |
| (254) 498-3929 | |
| Not Available |
| Full Name | Iconic Journey |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 14090 Southwest Fwy Ste 300, Sugar Land, Texas |
| Authorized Official Name and Position | Dawnica Mathis-huff (OWNER) |
| Authorized Official Contact | 8326093156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iconic Journey 14090 Southwest Fwy Ste 300 Sugar Land TX 77478-3679 Ph: (254) 498-3929 | Iconic Journey 14090 Southwest Fwy Ste 300 Sugar Land TX 77478-3679 Ph: (254) 498-3929 |
| NPI Number | 1174937387 |
|---|---|
| Provider Enumeration Date | 06/16/2014 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Medicare PECOS PAC ID | 3678887718 |
|---|---|
| Medicare Enrollment ID | O20150803000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174937387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Dawnica L Mathis-huff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780001701 PECOS PAC ID: 5799909073 Enrollment ID: I20140605001808 |
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