Provider Demographics
NPI:1265665715
Name:ABIDING CHRISTIAN THERAPY
Entity Type:Organization
Organization Name:ABIDING CHRISTIAN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PENNY LEZAK
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-453-2300
Mailing Address - Street 1:12655 WOODFOREST BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-3575
Mailing Address - Country:US
Mailing Address - Phone:713-453-2300
Mailing Address - Fax:713-453-2300
Practice Address - Street 1:12655 WOODFOREST BLVD STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-3575
Practice Address - Country:US
Practice Address - Phone:713-453-2300
Practice Address - Fax:713-453-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178749101Medicaid