Organization
EVOLVE OUTREACH OF TEXAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR MOODY (MANAGER)
(832) 930-4898
Entity
Organization
Contact information
Practice address
2101 CRAWFORD ST STE 311, HOUSTON, TX 77002-8941
(844) 553-8658
Mailing address
2101 CRAWFORD ST STE 311, HOUSTON, TX 77002-8941
(832) 930-4898
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
58768
TX
2084N0400X
Neurology Physician
Q4831
TX
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
05/11/2016
Last updated
06/23/2019
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