| Deer Oaks Southeast Llc | |
|
7272 Wurzbach Rd Suite 601 San Antonio TX 78240-4801 | |
| (210) 615-8880 | |
| (210) 593-9863 |
| Full Name | Deer Oaks Southeast Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7272 Wurzbach Rd, San Antonio, Texas |
| Authorized Official Name and Position | Paul A Boskind (CEO/OWNER) |
| Authorized Official Contact | 8883656271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer Oaks Southeast Llc 7272 Wurzbach Rd Suite 601 San Antonio TX 78240-4801 Ph: (888) 365-6271 | Deer Oaks Southeast Llc 7272 Wurzbach Rd Suite 601 San Antonio TX 78240-4801 Ph: (210) 615-8880 |
| NPI Number | 1619112612 |
|---|---|
| Provider Enumeration Date | 12/05/2008 |
| Last Update Date | 12/19/2017 |
| Medicare PECOS PAC ID | 7719251875 |
|---|---|
| Medicare Enrollment ID | O20170928000739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619112612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bong Soo Eun |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124275664 PECOS PAC ID: 7315008018 Enrollment ID: I20081212000096 |
| Provider Name | Stephen D Grasberger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336230143 PECOS PAC ID: 4284750654 Enrollment ID: I20100923000674 |
| Provider Name | Jacqueline M Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073614228 PECOS PAC ID: 1355505207 Enrollment ID: I20120606000167 |
| Provider Name | Cyreeta C Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508151747 PECOS PAC ID: 8628216900 Enrollment ID: I20130528000279 |
| Provider Name | Laura A Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225386683 PECOS PAC ID: 1951320464 Enrollment ID: I20140416001044 |
| Provider Name | Lana V Rickey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497801831 PECOS PAC ID: 5597986505 Enrollment ID: I20180831001897 |
| Provider Name | Mavis Gaskins Rowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396225058 PECOS PAC ID: 5496008807 Enrollment ID: I20181101002479 |
| Provider Name | Artesia Mcnair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275028359 PECOS PAC ID: 0840535332 Enrollment ID: I20190103001226 |
| Provider Name | Donna J Hutzler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740748938 PECOS PAC ID: 1355682048 Enrollment ID: I20190405001648 |
| Provider Name | Karen Rebecca Baugh-johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265044416 PECOS PAC ID: 8729405477 Enrollment ID: I20200826003977 |
| Provider Name | Jennifer Jordan Ford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407467194 PECOS PAC ID: 6800031360 Enrollment ID: I20200914001347 |
| Provider Name | Elaine S Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780156521 PECOS PAC ID: 6800204629 Enrollment ID: I20210415002918 |
| Provider Name | Stacy Michelle Saunders |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851065932 PECOS PAC ID: 4082011812 Enrollment ID: I20220324002294 |
| Provider Name | Katina L Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306041595 PECOS PAC ID: 8426445263 Enrollment ID: I20220426003144 |
| Provider Name | Sara Moody Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568938686 PECOS PAC ID: 3678806171 Enrollment ID: I20220427001986 |
| Provider Name | Oneida Burgos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528127339 PECOS PAC ID: 9830268150 Enrollment ID: I20230228002421 |
| Provider Name | Emmalyn Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487382230 PECOS PAC ID: 0840657607 Enrollment ID: I20230609000467 |
| Provider Name | Sharon B Hopkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518049147 PECOS PAC ID: 5092165803 Enrollment ID: I20231220000450 |
| Provider Name | Stephanie L Morehead |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962183087 PECOS PAC ID: 8224489174 Enrollment ID: I20240104004407 |
| Provider Name | Paul Cassidy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003071267 PECOS PAC ID: 8628418738 Enrollment ID: I20240506001777 |
| Provider Name | Michael Keith Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245294982 PECOS PAC ID: 2769924786 Enrollment ID: I20240605003991 |
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