Provider Demographics
NPI:1164783932
Name:GEYEN, DASHIEL
Entity Type:Individual
Prefix:
First Name:DASHIEL
Middle Name:
Last Name:GEYEN
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 1:2600 S LOOP W
Mailing Address - Street 2:SUITE 562
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2653
Mailing Address - Country:US
Mailing Address - Phone:713-337-2457
Mailing Address - Fax:
Practice Address - Street 1:6315 GULFTON ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1107
Practice Address - Country:US
Practice Address - Phone:713-457-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1466106H00000X
TX9783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist