Basic Information
| Provider Information | |||||||||
| NPI: | 1831658400 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLAUSER | ||||||||
| FirstName: | MARKELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10333 HARWIN DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770361545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134295114 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9401 SOUTHWEST FWY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770741407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139703354 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2019 | ||||||||
| LastUpdateDate: | 11/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator |
ID Information
| ID | Type | State | Issuer | Description | 171M00000X | 05 | TX | MEDICAID |