| Gulf Bend Center | |
|
6502 Nursery Dr Suite 100 Victoria TX 77904-1178 | |
| (361) 575-0611 | |
| (361) 575-0626 |
| Full Name | Gulf Bend Center |
|---|---|
| Speciality | Counselor |
| Location | 6502 Nursery Dr, Victoria, Texas |
| Authorized Official Name and Position | Jeffery Tunnell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3615750611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Bend Center 6502 Nursery Drive Suite 100 Victoria TX 77904 Ph: (361) 575-0611 | Gulf Bend Center 6502 Nursery Dr Suite 100 Victoria TX 77904-1178 Ph: (361) 575-0611 |
| NPI Number | 1467434399 |
|---|---|
| Provider Enumeration Date | 11/16/2005 |
| Last Update Date | 09/03/2024 |
| Certification Date | 01/12/2023 |
| Medicare PECOS PAC ID | 8628059631 |
|---|---|
| Medicare Enrollment ID | O20040526000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467434399 | NPI | - | NPPES |
| 135254407 | Medicaid | TX |
| Provider Name | Russel L Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003912924 PECOS PAC ID: 5395733497 Enrollment ID: I20040505001775 |
| Provider Name | Krishnaiah Rayasam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831188903 PECOS PAC ID: 6204802143 Enrollment ID: I20040902000667 |
| Provider Name | Giancarlo R Ferruzzi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891844866 PECOS PAC ID: 1456379437 Enrollment ID: I20051108000793 |
| Provider Name | James F Dotter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699759886 PECOS PAC ID: 4789604430 Enrollment ID: I20051128000272 |
| Provider Name | Sidney C. Ontai |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1225240443 PECOS PAC ID: 9436047131 Enrollment ID: I20080129000661 |
| Provider Name | Umamaheswara Rao Maruvada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053300103 PECOS PAC ID: 5799835765 Enrollment ID: I20090612000290 |
| Provider Name | Keith William Caramelli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538211941 PECOS PAC ID: 6204973886 Enrollment ID: I20091030000409 |
| Provider Name | Murthy V.s. Mangipudi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558350603 PECOS PAC ID: 3678615739 Enrollment ID: I20100127000764 |
| Provider Name | Holly Colleen Dubois |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518086511 PECOS PAC ID: 4880773092 Enrollment ID: I20100513001132 |
| Provider Name | Ziba Rezaee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902066236 PECOS PAC ID: 5092983908 Enrollment ID: I20110720000553 |
| Provider Name | Mario A Quintanilla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871552729 PECOS PAC ID: 0244402303 Enrollment ID: I20111013000541 |
| Provider Name | Theresa Olguin Ybarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043508344 PECOS PAC ID: 6901069236 Enrollment ID: I20120907000128 |
| Provider Name | Eboney P Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497093116 PECOS PAC ID: 8820233299 Enrollment ID: I20130408000253 |
| Provider Name | Anandkumar B Panchal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629453303 PECOS PAC ID: 7810291408 Enrollment ID: I20160202000337 |
| Provider Name | Angela R Covarrubias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932651734 PECOS PAC ID: 4183901044 Enrollment ID: I20170502000095 |
| Provider Name | Alicia A Vasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915266 PECOS PAC ID: 0941573588 Enrollment ID: I20170905000037 |
| Provider Name | Susan Zink |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174843510 PECOS PAC ID: 5092993824 Enrollment ID: I20180117001120 |
| Provider Name | Consuela D Witherspoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497802516 PECOS PAC ID: 8426307372 Enrollment ID: I20180827000161 |
| Provider Name | Grace H Kang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528563574 PECOS PAC ID: 2365799723 Enrollment ID: I20200403001665 |
| Provider Name | Darlyn Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740407386 PECOS PAC ID: 8729427612 Enrollment ID: I20240411001570 |
Region Iii Education Service Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1905 Leary Ln, Victoria, TX 77901 Phone: 361-573-0731 Fax: 361-573-1594 | |
Psychological Concepts Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 E Red River St, Suite A-1, Victoria, TX 77901 Phone: 361-578-2800 Fax: 361-578-2804 | |
Jack Greeson Phd & Associates Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5606 N Navarro, Ste 209, Victoria, TX 77904 Phone: 361-578-9190 Fax: 361-578-9206 | |
Uri L. Gonik, Ph.d. & Associates Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1001 E Airline Rd, Victoria, TX 77901 Phone: 361-575-5021 Fax: 361-575-0623 | |
Hatch Ventures, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4208 Retama Cir, Victoria, TX 77901 Phone: 361-578-2257 | |
Robert C. Lyman, Md, Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2710 Hospital Dr Ste 202, Victoria, TX 77901 Phone: 361-579-1388 Fax: 361-574-1571 | |
Popcorn Plus Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4702 N Laurent St, Suite D, Victoria, TX 77904 Phone: 361-572-0202 Fax: 361-572-0300 |