Provider Demographics
NPI:1992036826
Name:GOLTZ, HEATHER HONORE (PHD, LMSW, MED)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:HONORE
Last Name:GOLTZ
Suffix:
Gender:F
Credentials:PHD, LMSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 HOLCOMBE BLVD
Mailing Address - Street 2:MAIL STOP 152
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4211
Mailing Address - Country:US
Mailing Address - Phone:713-794-8675
Mailing Address - Fax:
Practice Address - Street 1:700 ROCKMEAD DR STE 212
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2587
Practice Address - Country:US
Practice Address - Phone:979-450-5364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53848104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker