Provider Demographics
NPI:1588791198
Name:ESPINOZA, TERESA PIQUEALGAZE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:PIQUEALGAZE
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:PIQUEALGAZE
Other - Last Name:ESPINOZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5800 RANCHESTER
Mailing Address - Street 2:SUITE #142
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2440
Mailing Address - Country:US
Mailing Address - Phone:713-271-8430
Mailing Address - Fax:713-271-3228
Practice Address - Street 1:5800 RANCHESTER
Practice Address - Street 2:SUITE #142
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2440
Practice Address - Country:US
Practice Address - Phone:713-271-8430
Practice Address - Fax:713-271-3228
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX034951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX064150801Medicaid
TX064150801Medicaid