1407197833 NPI number — HOUSTON PSC, LP

Table of content: MR. ARTHUR C. KUSSEROW LCSW (NPI 1154401644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407197833 NPI number — HOUSTON PSC, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON PSC, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407197833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15305 DALLAS PKWY
Provider Second Line Business Mailing Address:
SUITE 1600
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75001-4637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-389-7362
Provider Business Mailing Address Fax Number:
214-389-7350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12727 KIMBERLEY LN
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-4047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-799-9990
Provider Business Practice Location Address Fax Number:
713-796-1142
Provider Enumeration Date:
03/11/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER/AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
972-763-3859

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  130144 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)