Provider Demographics
NPI:1144375569
Name:PENTONY, CAROLE G (PHD)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:G
Last Name:PENTONY
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 1:8303 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 216
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1600
Mailing Address - Country:US
Mailing Address - Phone:713-271-4161
Mailing Address - Fax:713-771-3112
Practice Address - Street 1:8303 SOUTHWEST FWY
Practice Address - Street 2:SUITE 216
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1600
Practice Address - Country:US
Practice Address - Phone:713-271-4161
Practice Address - Fax:713-771-3112
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1187103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical