| Integrated Behavioral Health & Wellness Consultants, Pllc | |
|
2646 S Loop W 180 D Houston TX 77054-2665 | |
| (281) 997-7001 | |
| (888) 870-6542 |
| Full Name | Integrated Behavioral Health & Wellness Consultants, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2646 S Loop W, Houston, Texas |
| Authorized Official Name and Position | Diane Marie Boudreaux (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7132320034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Behavioral Health & Wellness Consultants, Pllc 3 Hermann Museum Circle Dr Apt 5108 Houston TX 77004-7970 Ph: (713) 232-0034 | Integrated Behavioral Health & Wellness Consultants, Pllc 2646 S Loop W 180 D Houston TX 77054-2665 Ph: (281) 997-7001 |
| NPI Number | 1568805364 |
|---|---|
| Provider Enumeration Date | 04/10/2013 |
| Last Update Date | 06/24/2015 |
| Medicare PECOS PAC ID | 1951542695 |
|---|---|
| Medicare Enrollment ID | O20130723000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568805364 | NPI | - | NPPES |
| 3259929 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 35073 (Texas) | Primary |
| Provider Name | Diane Marie Boudreaux |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568782068 PECOS PAC ID: 2860633500 Enrollment ID: I20130725000459 |
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