| Defining Paths,llc | |
|
433 Kitty Hawk Rd Ste 211 Universal City TX 78148-3829 | |
| (210) 763-8333 | |
| Not Available |
| Full Name | Defining Paths,llc |
|---|---|
| Speciality | Social Worker |
| Location | 433 Kitty Hawk Rd Ste 211, Universal City, Texas |
| Authorized Official Name and Position | Teresa Ann Hall (OWNER/CLINICIAN) |
| Authorized Official Contact | 2102647419 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Defining Paths,llc 113 Clear Oak Universal City TX 78148-3701 Ph: (210) 264-7419 | Defining Paths,llc 433 Kitty Hawk Rd Ste 211 Universal City TX 78148-3829 Ph: (210) 763-8333 |
| NPI Number | 1710526975 |
|---|---|
| Provider Enumeration Date | 01/04/2020 |
| Last Update Date | 01/05/2020 |
| Certification Date | 01/05/2020 |
| Medicare PECOS PAC ID | 3678909801 |
|---|---|
| Medicare Enrollment ID | O20200207000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710526975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Teresa Ann Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992269138 PECOS PAC ID: 6800136433 Enrollment ID: I20190319001242 |
| Provider Name | Lisa Marie Foerster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275288607 PECOS PAC ID: 9739573726 Enrollment ID: I20220309000737 |
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