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Organization
CANVAS MENTAL HEALTH PLLC
Active
Organization
CANVAS MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS H GAULTNEY APRN, PMHNP-BC (MANAGER)
(210) 985-1900
Entity
Organization
Contact information
Practice address
14603 HUEBNER RD STE 3505, SAN ANTONIO, TX 78230-5469
(210) 985-1900
(210) 985-1905
Mailing address
PO BOX 591245, SAN ANTONIO, TX 78259-0112
(210) 985-1900
(210) 985-1905
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/29/2021
Last updated
04/10/2023
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