Provider Demographics
NPI:1215028733
Name:GATES, TOM (MA)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:GATES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:GATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12727 FEATHERWOOD DR
Mailing Address - Street 2:STE 285
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034
Mailing Address - Country:US
Mailing Address - Phone:281-922-7333
Mailing Address - Fax:281-922-7369
Practice Address - Street 1:12727 FEATHERWOOD DR
Practice Address - Street 2:STE 285
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034
Practice Address - Country:US
Practice Address - Phone:281-922-7333
Practice Address - Fax:281-922-7369
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002003103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist