Organization
STBM LLC
Active
Organization
STBM LLC
Active
Parent organization
STBM LLC
Other names
South Texas Behavioral Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
STBM LLC
Authorized official
MRS. DIANE PENA (OFFICE MANAGER)
(210) 699-8881
Entity
Organization
Contact information
Practice address
12050 VANCE JACKSON, BLDG. 2, STE. 201, SAN ANTONIO, TX 78230-1183
(210) 699-8881
(210) 699-0503
Mailing address
12050 VANCE JACKSON, BLDG. 2, STE. 201, SAN ANTONIO, TX 78230-1183
(210) 699-8881
(210) 699-0503
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22545
TX
106H00000X
Marriage & Family Therapist
1884
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124053632
APRN, MSN, BC
TX
01
—
1174549109
MD
TX
01
—
1295743706
PHD
TX
01
—
1306857966
MD
TX
01
—
1427064062
MD
TX
01
—
1487689998
LPC, PHD
TX
01
—
1760408702
MD
TX
01
—
1851317895
LMFT, PHD, LPC
TX
Enumeration date
04/17/2007
Last updated
07/21/2022
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