| Life Center Healing And Cultural Place | |
|
26515 Oak Ridge Dr The Woodlands TX 77380-1966 | |
| (281) 367-0328 | |
| (281) 419-9753 |
| Full Name | Life Center Healing And Cultural Place |
|---|---|
| Speciality | Psychologist |
| Location | 26515 Oak Ridge Dr, The Woodlands, Texas |
| Authorized Official Name and Position | Missid G Ghanem (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2813670328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Center Healing And Cultural Place 26515 Oak Ridge Dr The Woodlands TX 77380-1966 Ph: (281) 367-0328 | Life Center Healing And Cultural Place 26515 Oak Ridge Dr The Woodlands TX 77380-1966 Ph: (281) 367-0328 |
| NPI Number | 1003015777 |
|---|---|
| Provider Enumeration Date | 07/13/2007 |
| Last Update Date | 05/13/2008 |
| Medicare PECOS PAC ID | 4880772367 |
|---|---|
| Medicare Enrollment ID | O20080424000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003015777 | NPI | - | NPPES |
| 1619082617 | Other | TX | INDIVIDUAL NPI |
| 097011302 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TF0000X | Psychologist - Family | 26864 (Texas) | Primary |
| Provider Name | Missid G Ghanem |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619082617 PECOS PAC ID: 7416051644 Enrollment ID: I20070328000462 |
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