Provider Demographics
NPI:1720762768
Name:TEJADA, ALFONSO (LPC)
Entity type:Individual
Prefix:
First Name:ALFONSO
Middle Name:
Last Name:TEJADA
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10575 WESTPARK DR APT 235
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-5248
Mailing Address - Country:US
Mailing Address - Phone:281-905-6509
Mailing Address - Fax:
Practice Address - Street 1:10575 WESTPARK DR APT 235
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-5248
Practice Address - Country:US
Practice Address - Phone:281-905-6509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health