Provider Demographics
NPI:1760565550
Name:LABAUVE, BILL J (EDD)
Entity type:Individual
Prefix:
First Name:BILL
Middle Name:J
Last Name:LABAUVE
Suffix:
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 1:775 INDIAN TRL STE 400
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-7026
Mailing Address - Country:US
Mailing Address - Phone:512-876-1151
Mailing Address - Fax:254-953-3236
Practice Address - Street 1:775 INDIAN TRL STE 400
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-7026
Practice Address - Country:US
Practice Address - Phone:512-876-1151
Practice Address - Fax:264-953-3236
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0285876-01Medicaid