Provider Demographics
NPI:1023170941
Name:DAVIS, MANUEL TERRY JR (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:TERRY
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:MS, LPC
Other - Prefix:
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Mailing Address - Street 1:7100 ALMEDA RD APT 1807
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2134
Mailing Address - Country:US
Mailing Address - Phone:713-457-4372
Mailing Address - Fax:713-457-0945
Practice Address - Street 1:9100 SOUTHWEST FWY
Practice Address - Street 2:SUITE 151
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1519
Practice Address - Country:US
Practice Address - Phone:713-457-4372
Practice Address - Fax:713-457-0945
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX19405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional