Provider Demographics
NPI:1487944609
Name:TARVER, VICTOR BRANDON
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:BRANDON
Last Name:TARVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 PIN OAK PARK APT 1531
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2295
Mailing Address - Country:US
Mailing Address - Phone:713-398-0291
Mailing Address - Fax:713-219-2005
Practice Address - Street 1:4848 PIN OAK PARK APT 1531
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2295
Practice Address - Country:US
Practice Address - Phone:713-398-0291
Practice Address - Fax:713-219-2005
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health