Provider Demographics
NPI:1669026548
Name:LOVE, NOEL ROBERT
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:ROBERT
Last Name:LOVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NASA PKWY STE 211B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3546
Mailing Address - Country:US
Mailing Address - Phone:713-447-5989
Mailing Address - Fax:
Practice Address - Street 1:1100 NASA PKWY STE 211B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3546
Practice Address - Country:US
Practice Address - Phone:713-447-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12849101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)