Provider Demographics
NPI:1407159205
Name:BEHAVIOR TLC, INC.
Entity Type:Organization
Organization Name:BEHAVIOR TLC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-499-1093
Mailing Address - Street 1:1001 PINELOCH DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2741
Mailing Address - Country:US
Mailing Address - Phone:281-461-6888
Mailing Address - Fax:
Practice Address - Street 1:1001 PINELOCH DR
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2741
Practice Address - Country:US
Practice Address - Phone:281-461-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health