Provider Demographics
NPI:1285889634
Name:PITTMAN, HENRY MARTEZ (MA)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:MARTEZ
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 LONG POINT RD STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3694
Mailing Address - Country:US
Mailing Address - Phone:800-419-2568
Mailing Address - Fax:832-900-9518
Practice Address - Street 1:7807 LONG POINT RD
Practice Address - Street 2:STE 440
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3679
Practice Address - Country:US
Practice Address - Phone:713-683-7395
Practice Address - Fax:713-683-7389
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9583101YA0400X
TX202608106H00000X
TX67531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist