Provider Demographics
NPI:1972050250
Name:FIGMENT ENTERPRISES
Entity type:Organization
Organization Name:FIGMENT ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:903-705-7595
Mailing Address - Street 1:418 S BROADWAY AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8101
Mailing Address - Country:US
Mailing Address - Phone:903-705-7595
Mailing Address - Fax:903-298-0076
Practice Address - Street 1:418 S BROADWAY AVE STE 600
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8101
Practice Address - Country:US
Practice Address - Phone:903-705-7595
Practice Address - Fax:903-298-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty