Provider Demographics
NPI:1619850062
Name:LASALLE, HILTON J III (EDD)
Entity type:Individual
Prefix:
First Name:HILTON
Middle Name:J
Last Name:LASALLE
Suffix:III
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 WENTWORTH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6510
Mailing Address - Country:US
Mailing Address - Phone:225-773-4347
Mailing Address - Fax:
Practice Address - Street 1:3830 WENTWORTH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6510
Practice Address - Country:US
Practice Address - Phone:225-773-4347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist