Organization
HOUSTON AREA COMMUNITY SERVICES, INC.
Active
Other names
Avenue 360 Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
TEQUILA HENDERSON (REVENUE CYCLE DIRECTOR)
(713) 426-0027
Entity
Organization
Contact information
Practice address
2150 W 18TH ST SUITE 300, HOUSTON, TX 77008-5200
(713) 426-0027
(832) 209-7186
Mailing address
2150 W 18TH ST STE 300, HOUSTON, TX 77008-1289
(713) 426-0027
(832) 209-7186
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202850804
—
TX
Enumeration date
04/23/2007
Last updated
10/30/2024
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