Basic Information
Provider Information
NPI: 1225508823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CORTES
FirstName: HIRAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2111 DIANA LOOP
Address2:  
City: HARKER HEIGHTS
State: TX
PostalCode: 765486085
CountryCode: US
TelephoneNumber: 2542519295
FaxNumber:  
Practice Location
Address1: 9401 SOUTHWEST FWY
Address2:  
City: HOUSTON
State: TX
PostalCode: 770741407
CountryCode: US
TelephoneNumber: 7139707000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/27/2018
LastUpdateDate: 07/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X77089TXY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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