Provider Demographics
NPI:1194878751
Name:GALVESTON BAPTIST ASSOCIATION
Entity type:Organization
Organization Name:GALVESTON BAPTIST ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY MINISTRY
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ZWARST
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LMFT
Authorized Official - Phone:281-728-6973
Mailing Address - Street 1:1221 CEDAR DR
Mailing Address - Street 2:PO BOX 907
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-3931
Mailing Address - Country:US
Mailing Address - Phone:281-728-6973
Mailing Address - Fax:409-938-1713
Practice Address - Street 1:1221 CEDAR DR
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-3931
Practice Address - Country:US
Practice Address - Phone:281-728-6973
Practice Address - Fax:409-938-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15193101YP2500X
TX4965106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty