Provider Demographics
NPI:1588836928
Name:HILTON, GLEN RICHARD (MS, LMFT)
Entity Type:Individual
Prefix:MR
First Name:GLEN
Middle Name:RICHARD
Last Name:HILTON
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541039
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-1039
Mailing Address - Country:US
Mailing Address - Phone:832-800-4500
Mailing Address - Fax:713-481-0210
Practice Address - Street 1:2855 MANGUM RD
Practice Address - Street 2:SUITE 465
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7493
Practice Address - Country:US
Practice Address - Phone:832-800-4500
Practice Address - Fax:713-481-0210
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMFT ASSOC 201187106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist