Provider Demographics
NPI:1548383045
Name:HOUSTON GALVESTON INSTITUTE
Entity Type:Organization
Organization Name:HOUSTON GALVESTON INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-526-8390
Mailing Address - Street 1:3316 MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3829
Mailing Address - Country:US
Mailing Address - Phone:713-526-8390
Mailing Address - Fax:713-528-2618
Practice Address - Street 1:3316 MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3829
Practice Address - Country:US
Practice Address - Phone:713-526-8390
Practice Address - Fax:713-528-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHOUST-0005OtherCOMPCARE GROUP NUMBER
TX10005289OtherAMERIGROUP PIN #