| Southtown Psychiatry Pllc | |
|
909 Ne Loop 410 Ste 600 San Antonio TX 78209-1309 | |
| (210) 332-2727 | |
| (210) 547-9537 |
| Full Name | Southtown Psychiatry Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 909 Ne Loop 410 Ste 600, San Antonio, Texas |
| Authorized Official Name and Position | Jason Miller (OWNER) |
| Authorized Official Contact | 2103322727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southtown Psychiatry Pllc 909 Ne Loop 410 Ste 600 San Antonio TX 78209-1309 Ph: (210) 460-0070 | Southtown Psychiatry Pllc 909 Ne Loop 410 Ste 600 San Antonio TX 78209-1309 Ph: (210) 332-2727 |
| NPI Number | 1346836681 |
|---|---|
| Provider Enumeration Date | 12/20/2020 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/05/2024 |
| Medicare PECOS PAC ID | 5698118842 |
|---|---|
| Medicare Enrollment ID | O20240205003727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346836681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Vanessa M Pfeffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649588062 PECOS PAC ID: 3173788791 Enrollment ID: I20120705000684 |
| Provider Name | Jason C Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285746974 PECOS PAC ID: 5294970703 Enrollment ID: I20130403000294 |
| Provider Name | Andrea M Seely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255710026 PECOS PAC ID: 7214246990 Enrollment ID: I20151020001552 |
| Provider Name | Alba Lara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073047767 PECOS PAC ID: 2961800743 Enrollment ID: I20211008000299 |
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