Provider Demographics
NPI:1457575292
Name:GEORGE, BIJU (MSW)
Entity Type:Individual
Prefix:
First Name:BIJU
Middle Name:
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 CREEK CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1517
Mailing Address - Country:US
Mailing Address - Phone:972-222-3342
Mailing Address - Fax:
Practice Address - Street 1:2725 CREEK CROSSING RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1517
Practice Address - Country:US
Practice Address - Phone:972-222-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health