Provider Demographics
NPI:1124390539
Name:BUTLER, LIND (MED)
Entity Type:Individual
Prefix:
First Name:LIND
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 EASTSIDE ST
Mailing Address - Street 2:SUITE 435
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1935
Mailing Address - Country:US
Mailing Address - Phone:713-522-9323
Mailing Address - Fax:713-520-8083
Practice Address - Street 1:3131 EASTSIDE ST
Practice Address - Street 2:SUITE 435
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1935
Practice Address - Country:US
Practice Address - Phone:713-522-9323
Practice Address - Fax:713-520-8083
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11187101YP2500X
TX2856106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist