TKT ENLIGHTENMENT, LLC (NPI# 1407128218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407128218 |
| Entity Type | Organization |
| Organization Name | TKT ENLIGHTENMENT, LLC |
| Practice Address |
17720 Corporate Woods Dr San Antonio TX 78259-3500 |
| Mailing Address |
17503 La Cantera Pkwy Suite 104, #485 San Antonio TX 78257-8207 |
| Practice Telephone | 2104953627 |
| Practice Fax Number | 2104913581 |
| Mailing Telephone | 2108578301 |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-05-25 |
| Authorized Official Name | DR. HENRY LYSELL POLK (CEO) |
| Authorized Official Telephone | 2108578301 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
M7529 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
17720 CORPORATE WOODS DR |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78259-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316932650 | George B Schneider | Internal Medicine | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2005-09-13 |
| 1992267801 | Raul Rivas | Licensed Vocational Nurse | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2019-04-01 |
| 1013489855 | Isabelle Bernadette Duque De Estrada | Counselor | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2018-12-18 |
| 1548769813 | April M Archuleta | Nurse Practitioner | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2018-02-01 |
| 1902255102 | Kambiz Jahanian | Psychiatry & Neurology | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2016-06-08 |
| 1801256169 | Calmm Staffing LLC | Psychiatric Hospital | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2016-02-29 |
| 1154703569 | Stephen Vincent Check | Registered Nurse | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2015-06-22 |
| 1659774156 | Olga C Chaves | Physician Assistant | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2014-09-29 |
| 1902216427 | Ijeoma Ajufo | Psychiatry & Neurology | 17720 Corporate Woods Dr, San Antonio, TX 78259 | 2014-05-06 |
| 1902169626 | Martha Jeanette Quiroga | Psychiatry & Neurology | 17720 Corporate Woods Dr, San Antonio, TX 78259-3500 | 2012-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952893448 | Greater Texas Palliative Care Services Pllc | Internal Medicine | 21806 Barton Woods, San Antonio, TX 78259 | 2018-05-31 |
| 1336639467 | Kriti Juneja | Behavioral Analyst | 21303 Encino Cmns Apt No1707, San Antonio, TX 78259 | 2018-05-14 |
| 1699121871 | Jesse Frank Delacruz | Nurse Practitioner | 21103 Simi Valley Drive, San Antonio, TX 78259 | 2016-05-06 |
| 1194139063 | Summer Ashley Kotson | Chiropractor | 2719 Rancho Mirage, San Antonio, TX 78259 | 2014-06-18 |
| 1194166645 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2502 Marshall Rd, San Antonio, TX 78259 | 2013-07-12 |
| 1174882369 | John Adams, Md Psychiatry Pllc | Psychiatric Unit | 17720 Corporate Woods Drive, San Antonio, TX 78259 | 2012-05-09 |
| 1508156589 | Kiddo Dental Pa | Dentist | 20306 Encino Ledge Ste 106, Kiddo Dental, San Antonio, TX 78259 | 2011-04-12 |
| 1386824217 | Austin Joseph Garrison | Dentist | 22100 Bulverde Rd, Suite 114, San Antonio, TX 78259 | 2007-11-08 |
| 1568584670 | Michael John Norgard | Internal Medicine | 226 Roseheart, San Antonio, TX 78259 | 2007-04-06 |
| 1225178817 | Texas Midwives Group | Midwife | 2211 Tworivers Dr., San Antonio, TX 78259 | 2007-02-06 |
| Find all providers in zip 78259 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588076343 | Amber Mansoor | Psychiatry & Neurology | 16007 Via Shavano Ste 101, San Antonio, TX 78249-2359 | 2014-05-28 |
| 1376858217 | Charles H. Sargent, M.d., P.a. | Psychiatry & Neurology | 2832 Nacogdoches Rd, San Antonio, TX 78217-5827 | 2010-08-16 |
| 1730372400 | Leonard Eugene Lawrence | Psychiatry & Neurology | 3107 Sable Crk, San Antonio, TX 78259-2636 | 2007-08-24 |
| 1124140793 | Lydia R Lopez, M.d., P.a. | Psychiatry & Neurology | 12915 Jones Maltsberger Rd Ste 603, San Antonio, TX 78247-4256 | 2007-04-04 |
| 1942372057 | John Charles Burnside | Psychiatry & Neurology | 13535 Jones Maltsberger Rd, San Antonio, TX 78247-3928 | 2006-11-14 |
| 1558446153 | Moises Gonzalo Rodriguez | Psychiatry & Neurology | 8535 Wurzbach Rd Ste 108, San Antonio, TX 78240-1263 | 2006-10-25 |
| 1972695021 | Elizabeth L. Mitchell | Psychiatry & Neurology | 11124 Wurzbach Rd Ste 300, San Antonio, TX 78230-2445 | 2006-09-28 |
| 1891707725 | Kenneth Lee Matthews | Psychiatry & Neurology | 13620 Nw Military Hwy., Bldg. 3, Suite 2, San Antonio, TX 78231 | 2006-08-12 |
| 1659382174 | Brigitte Bailey | Psychiatry & Neurology | 7703 Floyd Curl Dr # 7792, Uthscsa. Dept of Psychiatry, San Antonio, TX 78229-3901 | 2006-08-10 |
| 1316980816 | James A Rogers | Psychiatry & Neurology | 211 Patterson Ave, San Antonio, TX 78209-6230 | 2006-06-13 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78259 |
Please comment or provide details below to improve the information on TKT ENLIGHTENMENT, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.