| Deer Oaks Mid-west Llc | |
|
7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 | |
| (210) 615-3483 | |
| Not Available |
| Full Name | Deer Oaks Mid-west Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7272 Wurzbach Rd Ste 601, San Antonio, Texas |
| Authorized Official Name and Position | Paul A Boskind (CEO-OWNER) |
| Authorized Official Contact | 2106153483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer Oaks Mid-west Llc 7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 Ph: (210) 615-3483 | Deer Oaks Mid-west Llc 7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 Ph: (210) 615-3483 |
| NPI Number | 1154978476 |
|---|---|
| Provider Enumeration Date | 08/21/2019 |
| Last Update Date | 08/29/2023 |
| Certification Date | 08/29/2023 |
| Medicare PECOS PAC ID | 2264762681 |
|---|---|
| Medicare Enrollment ID | O20190927002974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154978476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jerome J Klinkner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124273149 PECOS PAC ID: 8527090497 Enrollment ID: I20050906000738 |
| Provider Name | Karyn B Cihak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770569402 PECOS PAC ID: 3274665377 Enrollment ID: I20100723000872 |
| Provider Name | Kelly Ann Pettit |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194999409 PECOS PAC ID: 5890988984 Enrollment ID: I20101021000562 |
| Provider Name | Carrie A Jura |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326357351 PECOS PAC ID: 4082874086 Enrollment ID: I20120329000166 |
| Provider Name | Patricia E Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568729473 PECOS PAC ID: 0749442101 Enrollment ID: I20120501000203 |
| Provider Name | Anna Sarenac |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134491137 PECOS PAC ID: 2466616651 Enrollment ID: I20120620000329 |
| Provider Name | Caryn E Kelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154763589 PECOS PAC ID: 1951544642 Enrollment ID: I20130828000416 |
| Provider Name | Starr L Baize |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457607848 PECOS PAC ID: 6901021427 Enrollment ID: I20140625001503 |
| Provider Name | Shani D Bensman-correa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306258033 PECOS PAC ID: 7810210168 Enrollment ID: I20141218000468 |
| Provider Name | Russell S Mccormack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881000826 PECOS PAC ID: 3173842317 Enrollment ID: I20150509000103 |
| Provider Name | Jean N Ackermans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104290345 PECOS PAC ID: 3870897192 Enrollment ID: I20160208000706 |
| Provider Name | George K Bialkowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669713475 PECOS PAC ID: 6608012570 Enrollment ID: I20160428001863 |
| Provider Name | Hope A Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588051767 PECOS PAC ID: 5991072183 Enrollment ID: I20170518000222 |
| Provider Name | Tomy K Kannala |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417430216 PECOS PAC ID: 1850643065 Enrollment ID: I20181016001186 |
| Provider Name | Alexander Chacko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417901620 PECOS PAC ID: 3476898586 Enrollment ID: I20181218002390 |
| Provider Name | Tracy Michelle Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023655750 PECOS PAC ID: 5890109573 Enrollment ID: I20210121001332 |
| Provider Name | Dana R Boyland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174787535 PECOS PAC ID: 9537444567 Enrollment ID: I20210527000691 |
| Provider Name | William Joseph Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902985534 PECOS PAC ID: 4587728464 Enrollment ID: I20210824003015 |
| Provider Name | Athanasia Nancy Metz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497412241 PECOS PAC ID: 8224428842 Enrollment ID: I20211214000350 |
| Provider Name | Joanne Marie Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629723309 PECOS PAC ID: 0648664680 Enrollment ID: I20220308001519 |
| Provider Name | Valentina Gasparro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669856431 PECOS PAC ID: 5597118059 Enrollment ID: I20240131003320 |
| Provider Name | Robert Lewis Stymets |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093053316 PECOS PAC ID: 3971045527 Enrollment ID: I20240611001046 |
| Provider Name | Krystina Brea Banks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801576384 PECOS PAC ID: 0042757544 Enrollment ID: I20240801003029 |
| Provider Name | Mary E Mckernan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245093160 PECOS PAC ID: 8820523566 Enrollment ID: I20241119000873 |
| Provider Name | John Augustine Nsimbi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285964742 PECOS PAC ID: 4880129766 Enrollment ID: I20241202002365 |
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