Provider Demographics
NPI:1427137660
Name:JAMAR, GREGORY P (MED, LPC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:P
Last Name:JAMAR
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 N MOODY ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5142
Mailing Address - Country:US
Mailing Address - Phone:361-572-8855
Mailing Address - Fax:
Practice Address - Street 1:1303 N MOODY ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5142
Practice Address - Country:US
Practice Address - Phone:361-572-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10627101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional