Provider Demographics
NPI:1699971234
Name:ZAZUETA, ADRIAN (BSD, LCDC)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:ZAZUETA
Suffix:
Gender:M
Credentials:BSD, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890008
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289-0008
Mailing Address - Country:US
Mailing Address - Phone:713-807-1500
Mailing Address - Fax:713-527-8558
Practice Address - Street 1:6065 MONTANA AVE STE C9
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1839
Practice Address - Country:US
Practice Address - Phone:915-881-8000
Practice Address - Fax:915-881-8108
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9540101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor