1588836928 NPI number — MR. GLEN RICHARD HILTON MS, LMFT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588836928 NPI number — MR. GLEN RICHARD HILTON MS, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILTON
Provider First Name:
GLEN
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS, LMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1588836928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 541039
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77254-1039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-800-4500
Provider Business Mailing Address Fax Number:
713-481-0210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2855 MANGUM RD
Provider Second Line Business Practice Location Address:
SUITE 465
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77092-7493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-800-4500
Provider Business Practice Location Address Fax Number:
713-481-0210
Provider Enumeration Date:
03/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LMFT ASSOC 201187 , 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)





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