Organization
ACT PSYCHIATRIC GENETICS CENTER P.A.
Active
Organization
ACT PSYCHIATRIC GENETICS CENTER P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESITA G BALDERAS MD (OWNER)
(210) 344-0506
Entity
Organization
Contact information
Practice address
84 NE LOOP 410, STE 140, SAN ANTONIO, TX 78216-5860
(210) 344-0506
(210) 344-3512
Mailing address
84 NE LOOP 410, STE 140, SAN ANTONIO, TX 78216-5860
(210) 344-0506
(210) 344-3512
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L0757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151316001
—
TX
Enumeration date
12/27/2007
Last updated
09/08/2009
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