| Autumn View Alliance | |
|
261 Turtle Ln Seguin TX 78155-3142 | |
| (210) 250-1298 | |
| Not Available |
| Full Name | Autumn View Alliance |
|---|---|
| Speciality | Psychologist |
| Location | 261 Turtle Ln, Seguin, Texas |
| Authorized Official Name and Position | Mary L. Trevino (PSYCHOLOGIST/MANAGER) |
| Authorized Official Contact | 2102501298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Autumn View Alliance 1136 E. Kingsbury St. Pmb 184 Seguin TX 78155-2148 Ph: (210) 250-1298 | Autumn View Alliance 261 Turtle Ln Seguin TX 78155-3142 Ph: (210) 250-1298 |
| NPI Number | 1821283177 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 11/03/2012 |
| Medicare PECOS PAC ID | 6901936103 |
|---|---|
| Medicare Enrollment ID | O20100615000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821283177 | NPI | - | NPPES |
| 166851903 | Medicaid | TX | |
| 166851902 | Medicaid | TX | |
| TXB101283 | Other | TX | MEDICARE GROUP |
| Provider Name | Lois L Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295812618 PECOS PAC ID: 0244124246 Enrollment ID: I20040211000235 |
| Provider Name | Melchor D Villarreal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295741874 PECOS PAC ID: 5395635163 Enrollment ID: I20040316001204 |
| Provider Name | Mary L Trevino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851428957 PECOS PAC ID: 8820069370 Enrollment ID: I20040809000457 |
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