Provider Demographics
NPI:1679668560
Name:YVONNE AUGUSTINE
Entity Type:Organization
Organization Name:YVONNE AUGUSTINE
Other - Org Name:MULTI CULTURAL COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DICTOR PSYCHIATRIC SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:GANC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-446-3740
Mailing Address - Street 1:1442 KINGWOOD DR
Mailing Address - Street 2:#103
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-446-3740
Mailing Address - Fax:281-446-8764
Practice Address - Street 1:1906 TREBLE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-446-3740
Practice Address - Fax:281-446-8764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2162Medicare ID - Type Unspecified
TX8F1808Medicare ID - Type Unspecified