| John Gabriel De La Fuente, MS | |
|
2114 Bahamas Dr Apt Edinburg, Edinburg, TX 78541-4960 | |
| (956) 358-8163 | |
| Not Available |
| Full Name | John Gabriel De La Fuente |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 2114 Bahamas Dr Apt Edinburg, Edinburg, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336716018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 77100 (Texas) | Primary |
| Entity Name | Sondermind Provider Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210326001541 |
| Mailing Address | Practice Location Address |
|---|---|
| John Gabriel De La Fuente, MS 2114 Bahamas Dr Apt 1, Edinburg, TX 78541-4960 Ph: (956) 358-8163 | John Gabriel De La Fuente, MS 2114 Bahamas Dr Apt Edinburg, Edinburg, TX 78541-4960 Ph: (956) 358-8163 |
Donna K Wallace, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1901 S 24th Ave, Edinburg, TX 78539 Phone: 956-289-7000 Fax: 956-289-7257 | |
Carolina I Campos, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5420 S Jackson Rd, Edinburg, TX 78539 Phone: 956-631-9000 Fax: 956-968-1402 | |
Raquel Ballesteros, Counselor Medicare: Not Enrolled in Medicare Practice Location: 506 Peabody Ave Apt 1, Edinburg, TX 78539 Phone: 956-564-9605 | |
Monica Lexcinne Perez, LPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 2121 W Champion St, Edinburg, TX 78539 Phone: 956-207-7490 | |
Itzel Michelle Hernandez, LPC ASSOCIATE, LCDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1409 S 9th Ave, Edinburg, TX 78539 Phone: 956-360-4244 | |
Anna Maria Castillo, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3118 Center Point Dr Ste 3, Edinburg, TX 78539 Phone: 956-687-8000 Fax: 956-687-8009 | |
Noe Americo Rios, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1512 E Silos Ave, Edinburg, TX 78542 Phone: 214-931-6934 |