Provider Demographics
NPI:1962254631
Name:RUBEN AND OFELIA IRACHETA PLLC
Entity type:Organization
Organization Name:RUBEN AND OFELIA IRACHETA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRACHETA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:956-443-6658
Mailing Address - Street 1:PO BOX 6329
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77491-6329
Mailing Address - Country:US
Mailing Address - Phone:956-443-6658
Mailing Address - Fax:
Practice Address - Street 1:2219 GREENHOUSE RD APT 1114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7322
Practice Address - Country:US
Practice Address - Phone:956-443-6658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty