| Medpsych Wellness Pllc | |
|
5282 Medical Dr Ste 605 San Antonio TX 78229-6114 | |
| (210) 908-6337 | |
| Not Available |
| Full Name | Medpsych Wellness Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5282 Medical Dr Ste 605, San Antonio, Texas |
| Authorized Official Name and Position | Edgar Samuel Medina (MANAGER) |
| Authorized Official Contact | 8184157968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medpsych Wellness Pllc 19141 Stone Oak Parkway Suite 104 Pmb 217 San Antonio TX 78258-3367 Ph: (210) 908-6337 | Medpsych Wellness Pllc 5282 Medical Dr Ste 605 San Antonio TX 78229-6114 Ph: (210) 908-6337 |
| NPI Number | 1447889258 |
|---|---|
| Provider Enumeration Date | 04/03/2020 |
| Last Update Date | 04/03/2020 |
| Certification Date | 04/03/2020 |
| Medicare PECOS PAC ID | 2466883640 |
|---|---|
| Medicare Enrollment ID | O20200505000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447889258 | NPI | - | NPPES |
| 1598045981 | Other | NATIONAL PLAN & PROVIDER ENUMERATION SYSTEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Edgar Samuel Medina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598045981 PECOS PAC ID: 9234429465 Enrollment ID: I20160601000140 |
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