Provider Demographics
NPI:1366592396
Name:MCDANIEL, JOSEPH ANTONIO III (LPC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTONIO
Last Name:MCDANIEL
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7806 MONTILLA COURT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083
Mailing Address - Country:US
Mailing Address - Phone:832-244-8769
Mailing Address - Fax:
Practice Address - Street 1:6630 HARWIN DR
Practice Address - Street 2:SUITE # 114-D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2245
Practice Address - Country:US
Practice Address - Phone:832-244-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20266101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180119301Medicare ID - Type UnspecifiedLPC