Provider Demographics
NPI:1649599390
Name:HULTS, TEYAH DEE
Entity Type:Individual
Prefix:
First Name:TEYAH
Middle Name:DEE
Last Name:HULTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3353 ELGIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-3531
Mailing Address - Country:US
Mailing Address - Phone:713-374-1227
Mailing Address - Fax:
Practice Address - Street 1:410 WILD PEACH PL
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5727
Practice Address - Country:US
Practice Address - Phone:281-253-6245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63359101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor