Provider Demographics
NPI:1124583067
Name:STRAIT, GILL
Entity Type:Individual
Prefix:
First Name:GILL
Middle Name:
Last Name:STRAIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 BARLETON WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2270
Mailing Address - Country:US
Mailing Address - Phone:803-360-4639
Mailing Address - Fax:
Practice Address - Street 1:1722 BARLETON WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2270
Practice Address - Country:US
Practice Address - Phone:803-360-4639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker