Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Other names
San Antonio State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY CARR (ASSOCIATE COMMISSIONER)
(512) 814-9642
Entity
Organization
Contact information
Practice address
6711 S NEW BRAUNFELS AVENUE, SUITE 100, SAN ANTONIO, TX 78223-3005
(210) 531-7805
(210) 531-7796
Mailing address
701 W 51ST ST, AUSTIN, TX 78751-2312
(512) 438-5618
(512) 438-4220
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
TX
103TC0700X
Clinical Psychologist
—
TX
183500000X
Pharmacist
—
TX
2084F0202X
Forensic Psychiatry Physician
—
TX
2084N0400X
Neurology Physician
—
TX
2084P0800X
Psychiatry Physician
—
TX
2084P0804X
Child & Adolescent Psychiatry Physician
—
TX
2084P0805X
Geriatric Psychiatry Physician
—
TX
208D00000X
General Practice Physician
—
TX
283Q00000X
Psychiatric Hospital
—
—
363A00000X
Physician Assistant
—
TX
363L00000X
Nurse Practitioner
—
TX
364S00000X
Clinical Nurse Specialist
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0638264-01
—
TX
05
—
0827974-01
—
TX
05
—
1387060-04
—
TX
05
—
1387060-05
—
TX
05
—
1387060-06
—
TX
05
—
1387060-07
—
TX
01
—
4589012
PHARMACY NCPDP NUMBER
TX
01
—
HH3015
BCBS DRUG/ALCOHOL
TX
01
—
HH4763
BCBS PSYCHIATRIC
TX
Enumeration date
08/09/2006
Last updated
02/22/2024
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