Provider Demographics
NPI:1669605846
Name:JIMENEZ, EMILIO (MA, LPC)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18123 TIMBER CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1520
Mailing Address - Country:US
Mailing Address - Phone:281-550-2744
Mailing Address - Fax:
Practice Address - Street 1:10001 WESTHEIMER RD
Practice Address - Street 2:SUITE 2115
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3151
Practice Address - Country:US
Practice Address - Phone:713-581-1008
Practice Address - Fax:713-782-0515
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional