DR. DALIA MATTIS ED D NPI 1003001074

Counselor in Houston, TX

About DALIA MATTIS

Dalia Mattis is a provider in Houston, TX. The NPI number assigned to this provider is 1003001074. The practitioner's primary taxonomy code is Counselor (101Y00000X). The provider is registered as an individual and their NPI record was last updated 11 years ago.

NPI

1003001074

Provider NameDR. DALIA MATTIS ED D
Provider Location Address5450 NW CENTRAL DR STE 109 HOUSTON, TX 77092
Provider Mailing Address5450 NW CENTRAL DR STE 109 HOUSTON, TX 77092
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date09-12-2007
Last Update Date09-12-2007

Primary Taxonomy

Taxonomy Code101Y00000X
ClassificationCounselor
TypeBehavioral Health & Social Service Providers
License No.17843
License StateTX
Taxonomy DescriptionA provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.

Business Address

DR. DALIA MATTIS ED D
5450 NW CENTRAL DR STE 109
HOUSTON, TX
ZIP 77092
Phone: (713) 895-0062
Fax: (713) 895-0062

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Mailing Address

DR. DALIA MATTIS ED D
5450 NW CENTRAL DR STE 109
HOUSTON, TX
ZIP 77092
Phone: (713) 895-0062
Fax: (713) 895-0062

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
165725601MEDICAID (05)TX

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1518152586 TANYA MATTIS
Individual
Counselor5450 NW CENTRAL DR STE 109
HOUSTON, TX 77092
(713) 895-0062

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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