Provider Demographics
NPI:1235815663
Name:GOWERS, BRADLEY JAY (MED, LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:JAY
Last Name:GOWERS
Suffix:
Gender:M
Credentials:MED, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 PLAZA DEL SOL PARK
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-7748
Mailing Address - Country:US
Mailing Address - Phone:281-787-2576
Mailing Address - Fax:
Practice Address - Street 1:633 E FERNHURST DR STE 1102
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1592
Practice Address - Country:US
Practice Address - Phone:281-940-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91736101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor