| Zen Imago Pllc | |
|
4800 Sugar Grove Blvd Suite 528 Stafford TX 77477 | |
| (832) 782-0001 | |
| Not Available |
| Full Name | Zen Imago Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4800 Sugar Grove Blvd, Stafford, Texas |
| Authorized Official Name and Position | Lola Clay (OWNER) |
| Authorized Official Contact | 8327820001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Zen Imago Pllc 9119 Highway 6 South Suite 189 Missouri City TX 77459 Ph: (832) 782-0001 | Zen Imago Pllc 4800 Sugar Grove Blvd Suite 528 Stafford TX 77477 Ph: (832) 782-0001 |
| NPI Number | 1891154266 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 02/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891154266 | NPI | - | NPPES |
| 207829703 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 63309 (Texas) | Primary |
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