Provider Demographics
NPI:1154695484
Name:MAZAS, CARLOS ADALBERTO (PHD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ADALBERTO
Last Name:MAZAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:ADALBERTO
Other - Last Name:MAZAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2501
Mailing Address - Country:US
Mailing Address - Phone:713-461-6262
Mailing Address - Fax:713-461-5111
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2501
Practice Address - Country:US
Practice Address - Phone:713-461-6262
Practice Address - Fax:713-461-5111
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35053103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist