Provider Demographics
NPI:1265090880
Name:AIDS FOUNDATION HOUSTON, INC.
Entity type:Organization
Organization Name:AIDS FOUNDATION HOUSTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BERTIN
Authorized Official - Last Name:HUCKABY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:713-623-6796
Mailing Address - Street 1:6260 WESTPARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7353
Mailing Address - Country:US
Mailing Address - Phone:713-623-6796
Mailing Address - Fax:713-623-4029
Practice Address - Street 1:6260 WESTPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7353
Practice Address - Country:US
Practice Address - Phone:713-623-6796
Practice Address - Fax:713-623-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health