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4439 Town Center Pl Kingwood TX 77339-3714 | |
| (713) 364-8032 | |
| (832) 442-3012 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4439 Town Center Pl, Kingwood, Texas |
| Authorized Official Name and Position | Jenny H. Jacobs (SOLE MEMBER) |
| Authorized Official Contact | 7133648032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5610 Rapid Brook Ct Kingwood TX 77345-1922 Ph: (713) 364-8032 | 4439 Town Center Pl Kingwood TX 77339-3714 Ph: (713) 364-8032 |
| NPI Number | 1992078430 |
|---|---|
| Provider Enumeration Date | 02/14/2012 |
| Last Update Date | 03/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992078430 | NPI | - | NPPES |
| 2832388 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 64668 (Texas) | Primary |
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