Provider Demographics
NPI:1659702082
Name:SPECIALIZED ASSESSMENT & CONSULTING, LLC
Entity type:Organization
Organization Name:SPECIALIZED ASSESSMENT & CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HITCHCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-240-1000
Mailing Address - Street 1:11301 FALLBROOK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4270
Mailing Address - Country:US
Mailing Address - Phone:346-240-1000
Mailing Address - Fax:281-754-4845
Practice Address - Street 1:11301 FALLBROOK DR STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4270
Practice Address - Country:US
Practice Address - Phone:346-240-1000
Practice Address - Fax:281-754-4845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34971103T00000X
TX115525225X00000X
TX104367235Z00000X
TX19780235Z00000X
TX016965251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3524282Medicaid
TX352428201Medicaid