Provider Demographics
NPI:1992187066
Name:FIRST BAPTIST CHURCH OF HOUSTON
Entity Type:Organization
Organization Name:FIRST BAPTIST CHURCH OF HOUSTON
Other - Org Name:JULIANNA POOR MEMORIAL COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE PASTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SELF
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:713-957-6780
Mailing Address - Street 1:7401 KATY FWY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2101
Mailing Address - Country:US
Mailing Address - Phone:713-335-6460
Mailing Address - Fax:
Practice Address - Street 1:7401 KATY FWY
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2101
Practice Address - Country:US
Practice Address - Phone:713-335-6460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty