SOUTH TEXAS NEUROBEHAVIORAL GROUP LLC (NPI# 1568738763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568738763 |
| Entity Type | Organization |
| Organization Name | SOUTH TEXAS NEUROBEHAVIORAL GROUP LLC |
| Practice Address |
3603 Paesanos Pkwy Suite 300 San Antonio TX 78231-1267 |
| Mailing Address |
Po Box 782087 San Antonio TX 78278-2087 |
| Practice Telephone | 2106143011 |
| Practice Fax Number | 2106156906 |
| Mailing Telephone | 2102412555 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |
| Authorized Official Name | DR. DOUGLAS B. COOPER (PRESIDENT) |
| Authorized Official Telephone | 2102412555 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 32263 | TX | Behavioral Health & Social Service Providers |
| Street Address |
3603 PAESANOS PKWY SUITE 300 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78231-1267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740286764 | Suzanne K Gazda | Psychiatry & Neurology | 3603 Paesanos Pkwy, Suite 300, San Antonio, TX 78231-1267 | 2005-06-23 |
| 1396145124 | Megan Vargas | Physician Assistant | 3603 Paesanos Pkwy, Suite 300, San Antonio, TX 78231-1267 | 2014-08-29 |
| 1881033504 | Shavano Precision Laboratory, LLC | Clinic/Center | 3603 Paesanos Pkwy, Suite 205b, San Antonio, TX 78231-1267 | 2013-06-15 |
| 1891008470 | Paesanos Parkway Imaging I LLC | Clinic/Center | 3603 Paesanos Pkwy, Suite 110, San Antonio, TX 78231-1267 | 2010-07-23 |
| 1003130543 | South Texas Neuropsychological Associates Pllc | Clinical Neuropsychologist | 3603 Paesanos Pkwy, Ste 300a, San Antonio, TX 78231-1267 | 2010-03-25 |
| 1609005305 | Kathy Baum Vonada | Counselor | 3603 Paesanos Pkwy, 202, San Antonio, TX 78231-1267 | 2009-07-02 |
| 1619150588 | Ellen S Vandelden | Psychiatry & Neurology | 3603 Paesanos Pkwy, Suite 300, San Antonio, TX 78231-1227 | 2007-12-13 |
| 1720008527 | Spine and Pain Center of San Antonio | Physical Medicine & Rehabilitation | 3603 Paesanos Pkwy, Suite 100, San Antonio, TX 78231-1227 | 2006-07-21 |
| 1376512350 | Merryl Leatherman | Physician Assistant | 3603 Paesanos Pkwy, Ste 300, San Antonio, TX 78231-1267 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790229516 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 3603 Paesanos Pkwy Ste 100, San Antonio, TX 78231 | 2016-12-13 |
| 1679945869 | Jocasta Castillo | Social Worker | Jewish Family Service of San Antonio, Tx, Inc., 12500 Nw Military Hwy Ste 250, San Antonio, TX 78231 | 2015-10-27 |
| 1710367297 | Amir Shahab Ashtiani | Dentist | 938 Wurzbach Pkwy Ste 107, San Antonio, TX 78231 | 2015-06-01 |
| 1386044303 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 919 Wurzbach Parkway, San Antonio, TX 78231 | 2014-08-27 |
| 1326452160 | Wal-mart Stores Texas, LLC | Technician/Technologist | 12639 Blanco Rd, San Antonio, TX 78231 | 2014-06-19 |
| 1306165378 | Rex Elwyn Wildey | Dentist | 10003 Nw Military Hwy, Suite 3201, San Antonio, TX 78231 | 2010-05-28 |
| 1003065095 | Gomes Dental, PC | Dentist | 4115 Pond Hill Rd, Suite 102, Shavano Park, TX 78231 | 2008-09-15 |
| 1801966320 | William Michael Copeland | Dentist | 2397 C Nw Military Hwy, San Antonio, TX 78231 | 2006-11-09 |
| 1588766802 | Eugene G Krenzer Jr. | Counselor | 12500 North West Military Hwy #250, Jewish Family and Children's Services, San Antonio, TX 78231 | 2006-09-05 |
| 1760590442 | Arlene G. Dryer | Social Worker | Jfcs, 12500 N.w. Military Hwy., #250, San Antonio, TX 78231 | 2006-08-25 |
| Find all providers in zip 78231 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1568824308 | Jonathan Highsmith | Clinical Neuropsychologist | 24203 Bear Mtn, San Antonio, TX 78258-7230 | 2016-03-22 |
| 1023354321 | Justin O'rourke | Clinical Neuropsychologist | 9643 Huebner Rd Ste 103, San Antonio, TX 78240-1752 | 2012-12-14 |
| 1336294891 | David Michael Richie | Clinical Neuropsychologist | 23029 S Fork, San Antonio, TX 78255-2105 | 2007-01-24 |
| 1073660262 | Cammy Chicota-carroll | Clinical Neuropsychologist | 7272 Wurzbach Rd Ste 706, San Antonio, TX 78240-4803 | 2007-01-03 |
| 1942383732 | Kate E Glywasky | Clinical Neuropsychologist | 7940 Floyd Curl Dive, Suite 1040, San Antonio, TX 78229-3606 | 2006-10-23 |
| 1558304543 | Daneen A Milam | Clinical Neuropsychologist | 147 West Sunset Road, Suite 101, San Antonio, TX 78209 | 2006-06-14 |
| 1588604615 | Katherine E. Goethe | Clinical Neuropsychologist | 6547 Bandera Rd, San Antonio, TX 78238-1434 | 2006-06-07 |
| 1679556930 | Janyna Marie Mercado | Clinical Neuropsychologist | 19016 Stone Oak Pkwy Ste 210, San Antonio, TX 78258-3281 | 2005-11-21 |
| 1619520681 | Johanna M. Messerly | Clinical Neuropsychologist | 8300 Floyd Curl Dr Fl 8, San Antonio, TX 78229-3931 | 2019-07-18 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78231 |
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| 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.