Provider Demographics
NPI:1760841506
Name:ARCHIE, GREGORY N SR
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:N
Last Name:ARCHIE
Suffix:SR
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 1:22307 SPRING CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-5070
Mailing Address - Country:US
Mailing Address - Phone:281-635-0183
Mailing Address - Fax:832-823-0156
Practice Address - Street 1:9330 W MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-4702
Practice Address - Country:US
Practice Address - Phone:281-635-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)