Provider Demographics
NPI:1184007197
Name:HERRON, VICTORIA B
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:B
Last Name:HERRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 NORTHBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-2552
Mailing Address - Country:US
Mailing Address - Phone:832-881-1264
Mailing Address - Fax:
Practice Address - Street 1:12700 NORTHBOROUGH DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-2552
Practice Address - Country:US
Practice Address - Phone:832-881-1264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52821104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker