Provider Demographics
NPI:1124518121
Name:DEER OAKS PSY
Entity type:Organization
Organization Name:DEER OAKS PSY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-439-6320
Mailing Address - Street 1:17070 RED OAK DR STE 209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2615
Mailing Address - Country:US
Mailing Address - Phone:832-225-3345
Mailing Address - Fax:
Practice Address - Street 1:17070 RED OAK DR STE 209
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2615
Practice Address - Country:US
Practice Address - Phone:832-225-3345
Practice Address - Fax:713-583-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty