Provider Demographics
NPI:1396406310
Name:THE HOUSTON PSYCHOLOGICAL SOURCE, PLLC
Entity Type:Organization
Organization Name:THE HOUSTON PSYCHOLOGICAL SOURCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASHUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDDLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-261-3549
Mailing Address - Street 1:1770 SAINT JAMES PL STE 206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3432
Mailing Address - Country:US
Mailing Address - Phone:713-261-3549
Mailing Address - Fax:
Practice Address - Street 1:1770 SAINT JAMES PL STE 206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3432
Practice Address - Country:US
Practice Address - Phone:346-666-6605
Practice Address - Fax:832-520-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty