| Gateway Online Counseling Pllc | |
|
910 Poydras St Sugar Land TX 77498-6355 | |
| (713) 899-0614 | |
| (713) 899-0614 |
| Full Name | Gateway Online Counseling Pllc |
|---|---|
| Speciality | Counselor |
| Location | 910 Poydras St, Sugar Land, Texas |
| Authorized Official Name and Position | Terry Azzouz (CEO) |
| Authorized Official Contact | 7138990614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Online Counseling Pllc 910 Poydras St Sugar Land TX 77498-6355 Ph: (713) 899-0614 | Gateway Online Counseling Pllc 910 Poydras St Sugar Land TX 77498-6355 Ph: (713) 899-0614 |
| NPI Number | 1821506627 |
|---|---|
| Provider Enumeration Date | 01/15/2018 |
| Last Update Date | 01/15/2018 |
| Medicare PECOS PAC ID | 0143762955 |
|---|---|
| Medicare Enrollment ID | O20240607003021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821506627 | NPI | - | NPPES |
| 1194843425 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 16335 (Texas) | Primary |
| Provider Name | Terry L Azzouz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477689610 PECOS PAC ID: 1052853868 Enrollment ID: I20240607003246 |
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