| Ayala-mylacraine Pllc | |
|
14350 Northbrook Dr Ste 140 San Antonio TX 78232-5011 | |
| (210) 854-5381 | |
| Not Available |
| Full Name | Ayala-mylacraine Pllc |
|---|---|
| Speciality | Counselor |
| Location | 14350 Northbrook Dr Ste 140, San Antonio, Texas |
| Authorized Official Name and Position | Haziel Williams (PARTNER) |
| Authorized Official Contact | 2108545380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ayala-mylacraine Pllc 14350 Northbrook Dr Ste 140 San Antonio TX 78232-5011 Ph: (210) 854-5381 | Ayala-mylacraine Pllc 14350 Northbrook Dr Ste 140 San Antonio TX 78232-5011 Ph: (210) 854-5381 |
| NPI Number | 1386400596 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/25/2024 |
| Medicare PECOS PAC ID | 9830535525 |
|---|---|
| Medicare Enrollment ID | O20240318000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386400596 | NPI | - | NPPES |
| Provider Name | Haziel Mccormick Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740984020 PECOS PAC ID: 0749626430 Enrollment ID: I20240318000107 |
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