Provider Demographics
NPI:1417224973
Name:TEXAS LIFE CENTER, LLC
Entity Type:Organization
Organization Name:TEXAS LIFE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-464-4944
Mailing Address - Street 1:14905 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5099
Mailing Address - Country:US
Mailing Address - Phone:832-464-4944
Mailing Address - Fax:
Practice Address - Street 1:6239 SPENCERS GLEN WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5059
Practice Address - Country:US
Practice Address - Phone:832-464-4944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35029251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health