Organization
PRECISION ADDICTION MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD PAUL GREEN III LCDC (CEO)
(210) 627-4017
Entity
Organization
Contact information
Practice address
7400 BLANCO RD STE 126, SAN ANTONIO, TX 78216-4361
(210) 627-4017
(210) 579-6873
Mailing address
7400 BLANCO RD STE 126, SAN ANTONIO, TX 78216-4361
(210) 627-4017
(210) 579-6873
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
173000000X
Legal Medicine
—
—
175T00000X
Peer Specialist
—
—
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
251B00000X
Case Management Agency
—
—
261QG0250X
Genetics Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32082447940
TEXAS TAX ID NUMBER
TX
Enumeration date
02/20/2023
Last updated
03/14/2023
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