Organization
BEHAVIORAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FESTUS UZOKWE MD (CHIEF EXECUTIVE OFFICER)
(832) 693-1300
Entity
Organization
Contact information
Practice address
12660 BEECHNUT ST STE 110, HOUSTON, TX 77072-3982
(832) 693-1300
Mailing address
4506 WILLIAMHURST LN, LEAGUE CITY, TX 77573-4534
(832) 693-1300
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
L9945
TX
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
L9945
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002800
—
TX
Enumeration date
08/22/2010
Last updated
08/30/2010
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