Basic Information
| Provider Information | |||||||||
| NPI: | 1699071852 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAPIA | ||||||||
| FirstName: | ANDRES | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5858 WESTHEIMER RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770575643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134879310 | ||||||||
| FaxNumber: | 7134891719 | ||||||||
| Practice Location | |||||||||
| Address1: | 5858 WESTHEIMER RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770575643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134879310 | ||||||||
| FaxNumber: | 7134891719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2011 | ||||||||
| LastUpdateDate: | 01/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 65233 | TX | N | Behavioral Health & Social Service Providers | Counselor | Professional | 103TC0700X | 37760 | TX | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 138708611 | 05 | TX | MEDICAID | 138708610 | 05 | TX | MEDICAID | 138708601 | 05 | TX | MEDICAID |