Provider Demographics
NPI:1730361296
Name:FASSIHI, THERESA CARMELA (PHD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:CARMELA
Last Name:FASSIHI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N POST OAK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3842
Mailing Address - Country:US
Mailing Address - Phone:713-750-9607
Mailing Address - Fax:713-750-9125
Practice Address - Street 1:730 N POST OAK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3842
Practice Address - Country:US
Practice Address - Phone:713-750-9607
Practice Address - Fax:713-750-9125
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31271103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical