Provider Demographics
NPI:1942535273
Name:HOUSTON OCD PROGRAM
Entity Type:Organization
Organization Name:HOUSTON OCD PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAHARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHROUT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:832-900-1271
Mailing Address - Street 1:1401 CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5703
Mailing Address - Country:US
Mailing Address - Phone:713-526-5055
Mailing Address - Fax:713-526-3226
Practice Address - Street 1:1401 CASTLE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5703
Practice Address - Country:US
Practice Address - Phone:713-526-5055
Practice Address - Fax:713-526-3226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31824103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty