# LIVE OAK PSYCHIATRIC AND FAMILY PRACTICE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003579913
- **Authorized official:** NAKEITRA CURTIS (CREDENTIALING MANAGER)
- **Authorized official phone:** (254) 466-1749

## Contact information

- **Practice address:** 1100 NW LOOP 410, SAN ANTONIO, TX 78213-2263
- **Practice address phone:** (347) 607-9126
- **Mailing address:** 11230 FOREST PASS CT, LIVE OAK, TX 78233-7236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/18/2021
- **Last updated:** 01/13/2022