Provider Demographics
NPI:1528721065
Name:KING, ALICE PAUL
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:PAUL
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALICE
Other - Middle Name:JAMIE
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3666 MEADOW LAKE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-4111
Mailing Address - Country:US
Mailing Address - Phone:713-202-4151
Mailing Address - Fax:
Practice Address - Street 1:3666 MEADOW LAKE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-4111
Practice Address - Country:US
Practice Address - Phone:713-202-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060551041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker