Provider Demographics
NPI:1528127040
Name:BRAGER, WILLIAM BRAD (MA, LPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRAD
Last Name:BRAGER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 HOLCOMBE BLVD
Mailing Address - Street 2:SUITE 3406
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4222
Mailing Address - Country:US
Mailing Address - Phone:713-459-4384
Mailing Address - Fax:713-781-3756
Practice Address - Street 1:808 TRAVIS ST
Practice Address - Street 2:SUITE 1507
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5706
Practice Address - Country:US
Practice Address - Phone:713-459-4384
Practice Address - Fax:713-781-3756
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 10012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3860LCOtherBLUE CROSS PROV NR