Provider Demographics
NPI:1558457846
Name:HOSCH, DANIEL LUTHER (LCDC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LUTHER
Last Name:HOSCH
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13127 COUNTY ROAD 3604
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75756-6050
Mailing Address - Country:US
Mailing Address - Phone:903-597-1351
Mailing Address - Fax:903-535-7331
Practice Address - Street 1:2323 W FRONT ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-7704
Practice Address - Country:US
Practice Address - Phone:903-597-1351
Practice Address - Fax:903-535-7331
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6684101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)