Provider Demographics
NPI:1417657727
Name:DRUMMOND, GREGORY DEWYAIN
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:DEWYAIN
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 CHISWELL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3221
Mailing Address - Country:US
Mailing Address - Phone:713-960-2833
Mailing Address - Fax:
Practice Address - Street 1:2907 CHISWELL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3221
Practice Address - Country:US
Practice Address - Phone:713-960-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15626101YA0400X
TX663241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)