Provider Demographics
NPI:1760670079
Name:DOUGLASS MEADOWS, JULIA V
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:V
Last Name:DOUGLASS MEADOWS
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:PO BOX 1502
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77572-1502
Mailing Address - Country:US
Mailing Address - Phone:832-794-0646
Mailing Address - Fax:281-867-0194
Practice Address - Street 1:4650 CENTER STREET
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536
Practice Address - Country:US
Practice Address - Phone:832-794-0646
Practice Address - Fax:281-867-0194
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health