Provider Demographics
NPI:1295207181
Name:TEXAS TRAINING INSTITUTE FOR THE FAMILY PLLC
Entity Type:Organization
Organization Name:TEXAS TRAINING INSTITUTE FOR THE FAMILY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:GERARDO
Authorized Official - Last Name:GALVAN-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-276-3686
Mailing Address - Street 1:1414 N MEADOW AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-8701
Mailing Address - Country:US
Mailing Address - Phone:956-744-5137
Mailing Address - Fax:956-462-5003
Practice Address - Street 1:1414 N MEADOW AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-8701
Practice Address - Country:US
Practice Address - Phone:956-744-5137
Practice Address - Fax:956-462-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)