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468 S Seguin Ave Ste. 401 New Braunfels TX 78130-7664 | |
| (830) 822-5054 | |
| (830) 629-9700 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 468 S Seguin Ave, New Braunfels, Texas |
| Authorized Official Name and Position | Louann C Wallis (PRESIDENT) |
| Authorized Official Contact | 8308225054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
468 S Seguin Ave Ste. 401 New Braunfels TX 78130-7664 Ph: (830) 822-5054 | 468 S Seguin Ave Ste. 401 New Braunfels TX 78130-7664 Ph: (830) 822-5054 |
| NPI Number | 1568592533 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568592533 | NPI | - | NPPES |
| 1167146 | Other | TX | INSURANCE PROVIDER ID |
| 232854 | Other | TX | INSURANCE PROVIDER ID |
| 239642 | Other | TX | INSURANCE PROVIDER ID |
| 12471 | Other | TX | INSURANCE PROVIDER ID |
| 1508894783 | Other | TX | INDIV. NPI |
| 506801 | Other | TX | INSURANCE PROVIDER ID |
| 5096LC | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 15933 (Texas) | Primary |
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