Provider Demographics
NPI:1669617528
Name:GARLAND, BETH (PHD)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:GARLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4769
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4769
Mailing Address - Country:US
Mailing Address - Phone:713-798-1978
Mailing Address - Fax:713-798-1188
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:CCC1710.00
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-822-3658
Practice Address - Fax:832-825-3689
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33914103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L8361Medicare PIN