Provider Demographics
NPI:1699655068
Name:KING, TRICIA SANDRA
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:SANDRA
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 LAUREL FOREST WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-2452
Mailing Address - Country:US
Mailing Address - Phone:813-802-7790
Mailing Address - Fax:
Practice Address - Street 1:2103 LAUREL FOREST WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2452
Practice Address - Country:US
Practice Address - Phone:813-802-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2217038103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist