institution
Idic Healthcare, Pllc
Multi-Specialty Clinic/Center in Houston, Texas
NPI 1174966915

Idic Healthcare, Pllc is a Multi-Specialty Clinic/Center based in Richmond, TX and is specialized in Multi-Specialty. Idic Healthcare, Pllc practices in Houston, TX. The NPI Number for Idic Healthcare, Pllc is 1174966915 and holds a License No. (Texas).

The current practice location address for Idic Healthcare, Pllc is 627 W. 19Th St., Houston, TX and can be reached out via phone at 832-248-4636 and via fax at 866-804-7241. You can also correspond with Idic Healthcare, Pllc through the mailing address at 5726 SAGAMORE BAY LN, RICHMOND, TX - 77469-7398 (mailing address contact number: 832-248-4636).

Location: 627 W. 19Th St., Houston, TX, 77469-7398
institution
Provider Profile Details
NPI Number
1174966915
Provider Name
Idic Healthcare, Pllc
Credential
Provider Entity Type
Organization
Address
627 W. 19Th St., Houston, TX, 77469-7398
Phone Number
832-248-4636
Fax Number
866-804-7241
Provider Enumeration Date
04/11/2013
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
31626 01 TX LBSW LICENSE NUMBER
5210 01 TX LMFT LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
627 W. 19Th St.
City
State
Zip
77008-3613
Phone Number
832-248-4636
Fax Number
866-804-7241
person
Provider Business Mailing Address Details
Address
5726 Sagamore Bay Ln
City
State
Zip
77469-7398
Phone Number
832-248-4636
Fax Number
866-804-7241
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
License No.
()
Definition
Definition to come...
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