Provider Demographics
NPI:1477249241
Name:ASHLIE LLORENS PHD, PLLC
Entity Type:Organization
Organization Name:ASHLIE LLORENS PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LLORENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-785-6994
Mailing Address - Street 1:15634 WALLISVILLE RD STE 800 #309
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3129 KINGSLEY DR STE 840
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8508
Practice Address - Country:US
Practice Address - Phone:281-785-6994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1700261757Medicaid