Provider Demographics
NPI:1073931226
Name:TEEN HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:TEEN HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAPPY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:409-766-5791
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77553-0925
Mailing Address - Country:US
Mailing Address - Phone:409-766-5791
Mailing Address - Fax:409-765-5026
Practice Address - Street 1:4115 AVENUE O
Practice Address - Street 2:ROOM 1003-B
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-6940
Practice Address - Country:US
Practice Address - Phone:409-766-5791
Practice Address - Fax:409-765-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX539821363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty