Provider Demographics
NPI:1740293539
Name:ROUZE, GLORIA JEAN (MED,,LPC,LMFT)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:JEAN
Last Name:ROUZE
Suffix:
Gender:F
Credentials:MED,,LPC,LMFT
Other - Prefix:MISS
Other - First Name:GLORIA
Other - Middle Name:JEAN
Other - Last Name:WAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 LAKESPUR DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5911
Mailing Address - Country:US
Mailing Address - Phone:281-565-2037
Mailing Address - Fax:281-565-5157
Practice Address - Street 1:4800 SUGAR GROVE BLVD.
Practice Address - Street 2:SUITE NUMBER 350
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2148
Practice Address - Country:US
Practice Address - Phone:281-491-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2073087OtherCIGNA
TX7102LCMedicare UPIN