Provider Demographics
NPI:1467103754
Name:MCCAIN, EDDIE ANDRE (ADMIN)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:ANDRE
Last Name:MCCAIN
Suffix:
Gender:M
Credentials:ADMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9894 BISSONNET ST STE 330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8241
Mailing Address - Country:US
Mailing Address - Phone:713-497-5344
Mailing Address - Fax:713-513-5439
Practice Address - Street 1:9894 BISSONNET ST STE 330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8241
Practice Address - Country:US
Practice Address - Phone:713-497-5344
Practice Address - Fax:713-513-5439
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health