Provider Demographics
NPI:1942789193
Name:CHOSEN BEHAVIORAL PLLC
Entity Type:Organization
Organization Name:CHOSEN BEHAVIORAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-781-8710
Mailing Address - Street 1:340 N SAM HOUSTON PKWY E STE 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3321
Mailing Address - Country:US
Mailing Address - Phone:831-781-8710
Mailing Address - Fax:877-346-7591
Practice Address - Street 1:340 N SAM HOUSTON PKWY E STE 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3321
Practice Address - Country:US
Practice Address - Phone:831-781-8710
Practice Address - Fax:877-346-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX831504291Medicaid