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Addiction Substance Use Disorder

Bedias, Texas

Provider NPI: 1073594776

Organization Information:
Organization is not Subpart
Authorized Official:  SHIRLEY FAYE SAMMONS-COX  THERAPIST  832-8770295

Practice Location:
23777 COUNTY ROAD 125  BEDIAS, TX 77831 US
Tel: 832-877-0295  Fax: 832-295-5752

Business Mailing Address:
23777 COUNTY ROAD 125  BEDIAS, TX 77831 US
Tel: 832-877-0295  Fax: 832-295-5752

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)
Y101YM0800XBehavioral Health & Social Service Providers
N106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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