Provider Demographics
NPI:1003420936
Name:MOOMAW, JAMES (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MOOMAW
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 HATTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3807
Mailing Address - Country:US
Mailing Address - Phone:713-598-5742
Mailing Address - Fax:
Practice Address - Street 1:5252 WESTCHESTER ST STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4100
Practice Address - Country:US
Practice Address - Phone:832-657-1492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist