Individual
MISS BEVERLY SHAW MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
6300 HILLCROFT ST STE 200, HOUSTON, TX 77081-3005
(281) 460-9590
(713) 278-9711
Mailing address
5631 HERON DR, HOUSTON, TX 77033-3131
(281) 460-9590
(713) 278-9711
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
11758
TX
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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