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14855 Blanco Rd Ste 355 San Antonio TX 78216-7731 | |
| (210) 896-4539 | |
| (210) 236-8991 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 14855 Blanco Rd Ste 355, San Antonio, Texas |
| Authorized Official Name and Position | Mahesh Kumar (OWNER) |
| Authorized Official Contact | 2108964539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 593499 San Antonio TX 78259-0224 Ph: () - | 14855 Blanco Rd Ste 355 San Antonio TX 78216-7731 Ph: (210) 896-4539 |
| NPI Number | 1306429816 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/09/2025 |
| Medicare PECOS PAC ID | 2163821075 |
|---|---|
| Medicare Enrollment ID | O20210526001610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306429816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mahesh Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871835900 PECOS PAC ID: 6002126588 Enrollment ID: I20210526001712 |
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