| Camino Real Community Mhmr Center | |
|
19965 Fm 3175 North Lytle TX 78052 | |
| (210) 357-0300 | |
| (210) 357-0458 |
| Full Name | Camino Real Community Mhmr Center |
|---|---|
| Speciality | Case Management |
| Location | 19965 Fm 3175 North, Lytle, Texas |
| Authorized Official Name and Position | Lisa Beth Ramirez (REIMBURSEMENT OFFICER) |
| Authorized Official Contact | 2103570365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Camino Real Community Mhmr Center Po Box 725 Lytle TX 78052-0725 Ph: (210) 357-0300 | Camino Real Community Mhmr Center 19965 Fm 3175 North Lytle TX 78052 Ph: (210) 357-0300 |
| NPI Number | 1154411262 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Medicare PECOS PAC ID | 9931183449 |
|---|---|
| Medicare Enrollment ID | O20040614001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154411262 | NPI | - | NPPES |
| 121990904 | Medicaid | TX |
| Provider Name | Stephanie M Lockett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629032073 PECOS PAC ID: 5991799173 Enrollment ID: I20040412000540 |
| Provider Name | Arif M Shoaib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407838394 PECOS PAC ID: 1850374695 Enrollment ID: I20040611000394 |
| Provider Name | Jacinto R Ybarra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740312958 PECOS PAC ID: 6103800636 Enrollment ID: I20040614001194 |
| Provider Name | Michael A Shiekh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386863397 PECOS PAC ID: 8729062146 Enrollment ID: I20040615000223 |
| Provider Name | Sharadamani Anandan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750490991 PECOS PAC ID: 0446236129 Enrollment ID: I20040624001112 |
| Provider Name | Robert C Strayhan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023178043 PECOS PAC ID: 7810980828 Enrollment ID: I20040817000043 |
| Provider Name | Murali Veeramachaneni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851374367 PECOS PAC ID: 8729041777 Enrollment ID: I20041110000497 |
| Provider Name | William T Goldman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962538488 PECOS PAC ID: 4082668140 Enrollment ID: I20050310000986 |
| Provider Name | Florence F Eddins Folensbee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700966041 PECOS PAC ID: 5890727754 Enrollment ID: I20050831000702 |
| Provider Name | Delwin Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942257209 PECOS PAC ID: 9335172626 Enrollment ID: I20050916000447 |
| Provider Name | Ricardo Enrique Irizarry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518926237 PECOS PAC ID: 4385669530 Enrollment ID: I20051007000076 |
| Provider Name | Pamela J Petersen-crair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023127271 PECOS PAC ID: 8820004278 Enrollment ID: I20060222000831 |
| Provider Name | Carlos F. Tirado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255388203 PECOS PAC ID: 7113920406 Enrollment ID: I20060804000177 |
| Provider Name | Rebecca Castro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326159799 PECOS PAC ID: 8820184724 Enrollment ID: I20071023000262 |
| Provider Name | Laurel Blackman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194752576 PECOS PAC ID: 5294816773 Enrollment ID: I20080123000152 |
| Provider Name | Tracie M Dejarnette Holly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699786681 PECOS PAC ID: 5890790109 Enrollment ID: I20080227000401 |
| Provider Name | Nilima N Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639250228 PECOS PAC ID: 4486730819 Enrollment ID: I20080326000511 |
| Provider Name | Lisa L Falls |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275604340 PECOS PAC ID: 2860578077 Enrollment ID: I20080328000272 |
| Provider Name | Preeti Sodhi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033268065 PECOS PAC ID: 7113089152 Enrollment ID: I20081229000377 |
| Provider Name | Gonzalo J Perez-garcia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801058672 PECOS PAC ID: 4385769298 Enrollment ID: I20100915001227 |
| Provider Name | Carolyn M Rekerdres |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104020346 PECOS PAC ID: 7911195367 Enrollment ID: I20101229000339 |
| Provider Name | Stephen Dai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629271432 PECOS PAC ID: 0244416964 Enrollment ID: I20110513000655 |
| Provider Name | Sara Flores |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073768248 PECOS PAC ID: 5294911608 Enrollment ID: I20110519000725 |
| Provider Name | Melissa Defilippis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689878274 PECOS PAC ID: 6002094703 Enrollment ID: I20110628000835 |
| Provider Name | Selma Raheem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699986109 PECOS PAC ID: 2961670922 Enrollment ID: I20110718000332 |
| Provider Name | Thomas M Sprague |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346353398 PECOS PAC ID: 3971522434 Enrollment ID: I20110913000425 |
| Provider Name | Marcelo Villarreal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083704613 PECOS PAC ID: 0547429581 Enrollment ID: I20120309000488 |
| Provider Name | Christopher Chee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447480173 PECOS PAC ID: 9537325329 Enrollment ID: I20120723000914 |
| Provider Name | Justin James Parrott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053677179 PECOS PAC ID: 5597921924 Enrollment ID: I20120730000285 |
| Provider Name | Roger G Joe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578755070 PECOS PAC ID: 6103090683 Enrollment ID: I20121001000431 |
| Provider Name | Johnes B Monyoncho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427301597 PECOS PAC ID: 4587815048 Enrollment ID: I20121108000620 |
| Provider Name | Cesar De Paz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568620672 PECOS PAC ID: 1254570294 Enrollment ID: I20130624000034 |
| Provider Name | Svetlana S Sembrano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467612036 PECOS PAC ID: 8628217502 Enrollment ID: I20130626000104 |
| Provider Name | Darice M Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043479892 PECOS PAC ID: 0042453607 Enrollment ID: I20130829000271 |
| Provider Name | Kellye Singletary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063433324 PECOS PAC ID: 5698918480 Enrollment ID: I20130829000722 |
| Provider Name | Jawad Riaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962425280 PECOS PAC ID: 9335185446 Enrollment ID: I20131021001316 |
| Provider Name | Shameem Shaik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134230840 PECOS PAC ID: 0143455386 Enrollment ID: I20131024001199 |
| Provider Name | Mark Schuchman |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1467517300 PECOS PAC ID: 2961683487 Enrollment ID: I20131104001245 |
| Provider Name | Seema S Varghees |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568625044 PECOS PAC ID: 5193953313 Enrollment ID: I20140116000155 |
| Provider Name | Linesse Maria Vega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114105897 PECOS PAC ID: 6002047206 Enrollment ID: I20140402000550 |
| Provider Name | Michael B Ang-rabanes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255566790 PECOS PAC ID: 3274756564 Enrollment ID: I20140513001576 |
| Provider Name | Rohini Ravindran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508091265 PECOS PAC ID: 4688899834 Enrollment ID: I20140702001883 |
| Provider Name | Victor G Stiebel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164423364 PECOS PAC ID: 7719889278 Enrollment ID: I20140811000605 |
| Provider Name | Donovan A Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437315967 PECOS PAC ID: 4082752688 Enrollment ID: I20140904002674 |
| Provider Name | Elizabeth Rdl Lobel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457596504 PECOS PAC ID: 7618123910 Enrollment ID: I20141016002683 |
| Provider Name | Gollavelli Krishna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871754036 PECOS PAC ID: 5092779223 Enrollment ID: I20141018000097 |
| Provider Name | Michele Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942473442 PECOS PAC ID: 7012181183 Enrollment ID: I20141111000893 |
| Provider Name | Deana G Abdel-reheim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467696591 PECOS PAC ID: 7315169984 Enrollment ID: I20141114001510 |
| Provider Name | Theresa D Bui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144576414 PECOS PAC ID: 7214253962 Enrollment ID: I20150224001338 |
| Provider Name | Damaris Chukwura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992100903 PECOS PAC ID: 8426374364 Enrollment ID: I20150311002033 |
| Provider Name | Silby J George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518362623 PECOS PAC ID: 5294053914 Enrollment ID: I20150409000662 |
| Provider Name | Jacob S Mays |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285953109 PECOS PAC ID: 1951629047 Enrollment ID: I20150422000659 |
| Provider Name | Shiny Abraham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740456144 PECOS PAC ID: 8527218841 Enrollment ID: I20150422001948 |
| Provider Name | Shaheena Minhas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750461141 PECOS PAC ID: 7911147723 Enrollment ID: I20150424002062 |
| Provider Name | Nazila A Adib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740202613 PECOS PAC ID: 8820045446 Enrollment ID: I20150505001782 |
| Provider Name | Natalia Kazakevich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447570999 PECOS PAC ID: 6608180542 Enrollment ID: I20150805008027 |
| Provider Name | Stephanie V Hernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215297221 PECOS PAC ID: 0042526683 Enrollment ID: I20150827002465 |
| Provider Name | Ashutosh Atri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215294004 PECOS PAC ID: 2668638693 Enrollment ID: I20150929002661 |
| Provider Name | Ronald St Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316032147 PECOS PAC ID: 0648201822 Enrollment ID: I20151001001342 |
| Provider Name | John D Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790169738 PECOS PAC ID: 7810206620 Enrollment ID: I20151019000741 |
| Provider Name | Christopher S Healey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659669315 PECOS PAC ID: 7810206265 Enrollment ID: I20151026000921 |
| Provider Name | Qingmin Ruan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548586308 PECOS PAC ID: 1456661842 Enrollment ID: I20151116001322 |
| Provider Name | Odochi P Onungwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811373673 PECOS PAC ID: 4183790678 Enrollment ID: I20151125000322 |
| Provider Name | John Kenny |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750449732 PECOS PAC ID: 9739102716 Enrollment ID: I20151217000691 |
| Provider Name | Kinshuk Bose |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598925497 PECOS PAC ID: 7517116700 Enrollment ID: I20160125001114 |
| Provider Name | Anandkumar B Panchal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629453303 PECOS PAC ID: 7810291408 Enrollment ID: I20160202000337 |
| Provider Name | Julia E Najara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063579084 PECOS PAC ID: 9335159409 Enrollment ID: I20160308002099 |
| Provider Name | Nicolas D Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023243995 PECOS PAC ID: 9032387576 Enrollment ID: I20160330001073 |
| Provider Name | Felix Geller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902073216 PECOS PAC ID: 2163672684 Enrollment ID: I20160811002590 |
| Provider Name | Deepak Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548403827 PECOS PAC ID: 7911022959 Enrollment ID: I20161025002615 |
| Provider Name | Biren P Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932543311 PECOS PAC ID: 8729368477 Enrollment ID: I20161215000175 |
| Provider Name | Gina Kim In |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861759672 PECOS PAC ID: 1658652938 Enrollment ID: I20161228000795 |
| Provider Name | Donna Brunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710434055 PECOS PAC ID: 6709168081 Enrollment ID: I20170120002315 |
| Provider Name | Sam Joseph Lowy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255412912 PECOS PAC ID: 9032018429 Enrollment ID: I20170125000093 |
| Provider Name | Katherine A Tharp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558743070 PECOS PAC ID: 2466732565 Enrollment ID: I20170223001905 |
| Provider Name | Lauren S Douglas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700147923 PECOS PAC ID: 8921375106 Enrollment ID: I20170518000071 |
| Provider Name | Hope M Camacho |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518124890 PECOS PAC ID: 1658648712 Enrollment ID: I20170522002178 |
| Provider Name | Micah J Knobles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144668831 PECOS PAC ID: 4789951310 Enrollment ID: I20170601001464 |
| Provider Name | Amara S Chudhary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326272279 PECOS PAC ID: 6800038720 Enrollment ID: I20170619001803 |
| Provider Name | Jessica C Reuben |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083974992 PECOS PAC ID: 9537441654 Enrollment ID: I20170717001292 |
| Provider Name | Lauren D Laporta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568438471 PECOS PAC ID: 6507031556 Enrollment ID: I20170807001427 |
| Provider Name | Mili M Khandheria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295094043 PECOS PAC ID: 4688947302 Enrollment ID: I20170831001718 |
| Provider Name | Alicia A Vasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915266 PECOS PAC ID: 0941573588 Enrollment ID: I20170905000037 |
| Provider Name | Marguerite M Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891186789 PECOS PAC ID: 7719244797 Enrollment ID: I20171129001710 |
| Provider Name | Susan Zink |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174843510 PECOS PAC ID: 5092993824 Enrollment ID: I20180117001120 |
| Provider Name | Sandra Neli Diaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730539602 PECOS PAC ID: 2466732219 Enrollment ID: I20180208000469 |
| Provider Name | Samuel D Scott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831584069 PECOS PAC ID: 9931461134 Enrollment ID: I20180328002205 |
| Provider Name | Thomas R Milam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669457677 PECOS PAC ID: 5294727889 Enrollment ID: I20180605000705 |
| Provider Name | Lorena Elizabeth Reyna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467872580 PECOS PAC ID: 3173893203 Enrollment ID: I20180613002156 |
| Provider Name | Hector L Rivera Reyes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457583585 PECOS PAC ID: 9739302340 Enrollment ID: I20180702000570 |
| Provider Name | Jennifer C Schaefer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750782215 PECOS PAC ID: 0941508139 Enrollment ID: I20180702001323 |
| Provider Name | Zachary J Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568880094 PECOS PAC ID: 7416204987 Enrollment ID: I20180716002580 |
| Provider Name | Consuela D Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497802516 PECOS PAC ID: 8426307372 Enrollment ID: I20180827000161 |
| Provider Name | Eliza Karwowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861810384 PECOS PAC ID: 4789934860 Enrollment ID: I20180911002962 |
| Provider Name | Christina S Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396159679 PECOS PAC ID: 0648523282 Enrollment ID: I20181029000500 |
| Provider Name | Daniel R Lavin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750676532 PECOS PAC ID: 3072883859 Enrollment ID: I20181207000870 |
| Provider Name | Andre Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023162559 PECOS PAC ID: 6406917285 Enrollment ID: I20181219002884 |
| Provider Name | Ryan Landis Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750760948 PECOS PAC ID: 6103131495 Enrollment ID: I20190117002183 |
| Provider Name | Zachary Robert Drennan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841728011 PECOS PAC ID: 8325317076 Enrollment ID: I20190123000520 |
| Provider Name | Jamon Blood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316333552 PECOS PAC ID: 8426341926 Enrollment ID: I20190130001747 |
| Provider Name | Kari Whatley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033505979 PECOS PAC ID: 3375853856 Enrollment ID: I20190404001661 |
| Provider Name | Angeline Trinh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922427228 PECOS PAC ID: 3173829348 Enrollment ID: I20190410002009 |
| Provider Name | Daniel Bustillos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881182160 PECOS PAC ID: 1759622939 Enrollment ID: I20190417000163 |
| Provider Name | Nicholas F Ortiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164878914 PECOS PAC ID: 8628305612 Enrollment ID: I20190814001400 |
| Provider Name | Kelly A Campbell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205240611 PECOS PAC ID: 9739478595 Enrollment ID: I20190828002958 |
| Provider Name | Christine Nkem Chioma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083972608 PECOS PAC ID: 6406005537 Enrollment ID: I20190910001227 |
| Provider Name | Vanitha D Kothapalli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164788709 PECOS PAC ID: 2062716681 Enrollment ID: I20200402000682 |
| Provider Name | Grace Kang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528563574 PECOS PAC ID: 2365799723 Enrollment ID: I20200403001665 |
| Provider Name | Stacen J Velvin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285124743 PECOS PAC ID: 8729335120 Enrollment ID: I20200601000022 |
| Provider Name | Brian V Clinton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811481898 PECOS PAC ID: 2365799798 Enrollment ID: I20200812002785 |
| Provider Name | Scott J Tlanda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720440431 PECOS PAC ID: 6507283793 Enrollment ID: I20200902002186 |
| Provider Name | Malaika Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063875847 PECOS PAC ID: 6608296645 Enrollment ID: I20201013003620 |
| Provider Name | Saraswathi Tirumalasetty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821006172 PECOS PAC ID: 1355606401 Enrollment ID: I20201123001601 |
| Provider Name | Eva Studer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437545852 PECOS PAC ID: 1850706698 Enrollment ID: I20210209001086 |
| Provider Name | Caylin Cervetti Moen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164883500 PECOS PAC ID: 0648525725 Enrollment ID: I20210222002280 |
| Provider Name | Victor Vasquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154408268 PECOS PAC ID: 5698667145 Enrollment ID: I20210226000118 |
| Provider Name | Laura Ann Beaufford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619563343 PECOS PAC ID: 2668889122 Enrollment ID: I20210329002248 |
| Provider Name | Delia Sanchez Patino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528640331 PECOS PAC ID: 4688077290 Enrollment ID: I20210720003323 |
| Provider Name | Alba Lara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073047767 PECOS PAC ID: 2961800743 Enrollment ID: I20211008000299 |
| Provider Name | Katherine M Chapel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386938306 PECOS PAC ID: 8224436068 Enrollment ID: I20211008002555 |
| Provider Name | Cheryl A France |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134144215 PECOS PAC ID: 1557550175 Enrollment ID: I20211103001493 |
| Provider Name | Carla J Sikkema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023771862 PECOS PAC ID: 7113317926 Enrollment ID: I20211210000929 |
| Provider Name | Marketa Danyalle Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699208272 PECOS PAC ID: 0648514000 Enrollment ID: I20211216002889 |
| Provider Name | Najma F Hamdani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588929806 PECOS PAC ID: 3173845401 Enrollment ID: I20220121001211 |
| Provider Name | Brittany Manor |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1417449356 PECOS PAC ID: 1052716073 Enrollment ID: I20220215001606 |
| Provider Name | Jennifer Rose Iruegas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295402865 PECOS PAC ID: 0143614289 Enrollment ID: I20220307000436 |
| Provider Name | Michael Watkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932761640 PECOS PAC ID: 6901132620 Enrollment ID: I20220308002515 |
| Provider Name | Andrew Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558867465 PECOS PAC ID: 6709132459 Enrollment ID: I20220428000667 |
| Provider Name | Colette Helene Kendrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073074019 PECOS PAC ID: 0749669190 Enrollment ID: I20220615002394 |
| Provider Name | Cassandra Boduch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083177497 PECOS PAC ID: 2163803487 Enrollment ID: I20220719000165 |
| Provider Name | Eneida Miranda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598293284 PECOS PAC ID: 6305266123 Enrollment ID: I20220815002830 |
| Provider Name | Leigh A Ware |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972506251 PECOS PAC ID: 5395790828 Enrollment ID: I20220817003280 |
| Provider Name | Kyle M Hodges |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134756455 PECOS PAC ID: 4880015650 Enrollment ID: I20220831000479 |
| Provider Name | Van Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194214429 PECOS PAC ID: 0749664258 Enrollment ID: I20220901001924 |
| Provider Name | Marisela Munoz Puga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710515994 PECOS PAC ID: 8325415540 Enrollment ID: I20221101001599 |
| Provider Name | John J Byun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932763620 PECOS PAC ID: 5991035883 Enrollment ID: I20221107000363 |
| Provider Name | Chinwe L Osuagwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063148195 PECOS PAC ID: 3870959166 Enrollment ID: I20230511000300 |
| Provider Name | Sayyeda Tooba Hasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164929394 PECOS PAC ID: 5991051054 Enrollment ID: I20230522002721 |
| Provider Name | Lisa C Diamond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184710550 PECOS PAC ID: 6800924663 Enrollment ID: I20230531000014 |
| Provider Name | Cassandra M Ortiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477281889 PECOS PAC ID: 2264880301 Enrollment ID: I20231129002541 |
| Provider Name | Jazmyn J Contreras |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891491346 PECOS PAC ID: 5395193437 Enrollment ID: I20231129002820 |
| Provider Name | Corrina M Ramirez-cortez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578198180 PECOS PAC ID: 2264882851 Enrollment ID: I20231221004123 |
| Provider Name | Leah N Vernia-amend |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598109746 PECOS PAC ID: 5597115857 Enrollment ID: I20231228002175 |
| Provider Name | Andy James Overgard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457064651 PECOS PAC ID: 3779933056 Enrollment ID: I20231228002957 |
| Provider Name | Jack K Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922872209 PECOS PAC ID: 9638520612 Enrollment ID: I20240104001688 |
| Provider Name | Nelson A Rodriguez Guerrero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093269417 PECOS PAC ID: 5698127959 Enrollment ID: I20240123001006 |
| Provider Name | Jacob Pizana |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780152447 PECOS PAC ID: 2961854419 Enrollment ID: I20240123004017 |
| Provider Name | Antoun Y Antoun |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629350715 PECOS PAC ID: 5991158172 Enrollment ID: I20240124004019 |
| Provider Name | Robert D Schales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740902493 PECOS PAC ID: 0042663189 Enrollment ID: I20240125001106 |
| Provider Name | Sandra K Fleming |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588765515 PECOS PAC ID: 7911350053 Enrollment ID: I20240125001231 |
| Provider Name | Philomena C Toomey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740845718 PECOS PAC ID: 9739532219 Enrollment ID: I20240131003924 |
| Provider Name | Cynthia A Chapa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912297615 PECOS PAC ID: 4880047281 Enrollment ID: I20240201003013 |
| Provider Name | Gloria L Ortiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609838069 PECOS PAC ID: 8527401371 Enrollment ID: I20240208001209 |
| Provider Name | Melanie P Trevino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336635374 PECOS PAC ID: 7315380144 Enrollment ID: I20240208003609 |
| Provider Name | Joshua Petty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609649987 PECOS PAC ID: 7012350473 Enrollment ID: I20240213002246 |
| Provider Name | Claudette M Ponton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225803125 PECOS PAC ID: 4587009584 Enrollment ID: I20240229002266 |
| Provider Name | Tracey Onyinyechukwu Okwara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528621323 PECOS PAC ID: 0648505479 Enrollment ID: I20240829002213 |
| Provider Name | Samantha D Shaffer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366255267 PECOS PAC ID: 9638609068 Enrollment ID: I20250213002922 |
| Provider Name | Hayden H Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265194823 PECOS PAC ID: 8921528431 Enrollment ID: I20250228001871 |
Country Breeze Counseling Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16486 Fm 463, Lytle, TX 78052 Phone: 830-709-0711 Fax: 830-772-3808 | |
Camino Real Community Mhmr Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19965 Fm 3175 North, Lytle, TX 78052 Phone: 210-357-0300 Fax: 210-357-0458 | |
Camino Real Community Mhmr Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19965 Fm 3175, Lytle, TX 78052 Phone: 210-357-0300 Fax: 830-772-4305 | |
Camino Real Community Mhmr Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19965 Fm 3175 N, Lytle, TX 78052 Phone: 210-357-0300 Fax: 855-240-1374 |