Provider Demographics
NPI:1265762595
Name:HOUSTON MIND-BODY COUNSELING, LLC
Entity type:Organization
Organization Name:HOUSTON MIND-BODY COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD ANP-C PMHCNS-BC
Authorized Official - Phone:713-523-4333
Mailing Address - Street 1:13201 NORTHWEST FWY STE 770
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6233
Mailing Address - Country:US
Mailing Address - Phone:713-523-4333
Mailing Address - Fax:713-523-4493
Practice Address - Street 1:13201 NORTHWEST FWY STE 770
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6233
Practice Address - Country:US
Practice Address - Phone:713-523-4333
Practice Address - Fax:713-523-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548373363LA2200X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty