Active NPI
Ann Gustavus
- Professional Counselor
- Porter, TX
National Provider Identifier
1528496312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 64248
- Practice address
- 19871 N Star Dr
Porter, TX 77365-3043 - Phone
- (713) 857-2038
- NPI assigned
- Oct 15, 2013
- Last updated
- Oct 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 64248 | TX | Primary |
Addresses
Primary practice location
19871 N Star Dr
Porter, TX 77365-3043
Mailing address
19871 N Star Dr
Porter, TX 77365-3043
Phone (713) 857-2038
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64248 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381795200000",
"number": "1528496312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19871 N STAR DR",
"city": "PORTER",
"state": "TX",
"postal_code": "773653043",
"telephone_number": "713-857-2038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19871 N STAR DR",
"city": "PORTER",
"state": "TX",
"postal_code": "773653043",
"telephone_number": "713-857-2038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAVUS",
"first_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-15",
"last_updated": "2013-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "64248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Porter, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.