Provider Demographics
NPI:1891834693
Name:ODEMS, RUBEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:
Last Name:ODEMS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10926 CASTLE PEAK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4491
Mailing Address - Country:US
Mailing Address - Phone:281-373-0817
Mailing Address - Fax:
Practice Address - Street 1:10926 CASTLE PEAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4491
Practice Address - Country:US
Practice Address - Phone:281-373-0817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical