Provider Demographics
NPI:1457958803
Name:COBO, OMAR (LPC)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:COBO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17047 EL CAMINO REAL STE 225
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2671
Mailing Address - Country:US
Mailing Address - Phone:832-885-4056
Mailing Address - Fax:
Practice Address - Street 1:17047 EL CAMINO REAL SUITE 225
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2671
Practice Address - Country:US
Practice Address - Phone:281-386-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80913101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional