Provider Demographics
NPI: | 1205155173 |
---|---|
Name: | TEXAS TREATMENT CENTERS INC |
Entity type: | Organization |
Organization Name: | TEXAS TREATMENT CENTERS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | IGNACIO |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | VALDES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 713-956-7712 |
Mailing Address - Street 1: | 4800 W 34TH ST |
Mailing Address - Street 2: | SUITE B-3 |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77092-6680 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-956-7712 |
Mailing Address - Fax: | 713-956-7959 |
Practice Address - Street 1: | 4800 W 34TH ST |
Practice Address - Street 2: | SUITE B-3 |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77092-6680 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-956-7712 |
Practice Address - Fax: | 713-956-7959 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-05-18 |
Last Update Date: | 2024-02-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | CFN0000044 | 261QM2800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | Methadone |