| Shape Center | |
|
326 N Lbj Dr Ste 198 San Marcos TX 78666-5624 | |
| (323) 717-9568 | |
| Not Available |
| Full Name | Shape Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 326 N Lbj Dr Ste 198, San Marcos, Texas |
| Authorized Official Name and Position | Ninette Antoinette Threatt (BCBA) |
| Authorized Official Contact | 3237179568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shape Center 326 N Lbj Dr Ste 198 San Marcos TX 78666-5624 Ph: (323) 717-9568 | Shape Center 326 N Lbj Dr Ste 198 San Marcos TX 78666-5624 Ph: (323) 717-9568 |
| NPI Number | 1659082907 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659082907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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