Provider Demographics
NPI:1295089639
Name:CORTEZ, CELIX
Entity type:Individual
Prefix:
First Name:CELIX
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 VILLAGE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1028
Mailing Address - Country:US
Mailing Address - Phone:281-944-5459
Mailing Address - Fax:
Practice Address - Street 1:17510 HUFFMEISTER RD STE 103
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6785
Practice Address - Country:US
Practice Address - Phone:281-373-5200
Practice Address - Fax:281-373-5202
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional