| Genesis Neuropsychiatric Center | |
|
1380 Pantheon Way #310 San Antonio TX 78232-2288 | |
| (210) 404-9696 | |
| (210) 404-9466 |
| Full Name | Genesis Neuropsychiatric Center |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1380 Pantheon Way, San Antonio, Texas |
| Authorized Official Name and Position | E.p Ted Williams (P.A.) |
| Authorized Official Contact | 2104049696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Neuropsychiatric Center 1380 Pantheon Way #310 San Antonio TX 78232-2288 Ph: (210) 404-9696 | Genesis Neuropsychiatric Center 1380 Pantheon Way #310 San Antonio TX 78232-2288 Ph: (210) 404-9696 |
| NPI Number | 1518190859 |
|---|---|
| Provider Enumeration Date | 09/03/2009 |
| Last Update Date | 09/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518190859 | NPI | - | NPPES |
| 138419010 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G3912 (Texas) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | G3912 (Texas) | Secondary |
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