| Sunrise Total Mind Wellness, Pllc | |
|
1260 River Acres Dr New Braunfels TX 78130-3689 | |
| (830) 730-4194 | |
| (830) 302-2092 |
| Full Name | Sunrise Total Mind Wellness, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1260 River Acres Dr, New Braunfels, Texas |
| Authorized Official Name and Position | Veronica Harlan (CREDENTIALING MANGER) |
| Authorized Official Contact | 8307305025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Total Mind Wellness, Pllc 1672 Independence Dr Ste 310 New Braunfels TX 78132-3982 Ph: (830) 730-5025 | Sunrise Total Mind Wellness, Pllc 1260 River Acres Dr New Braunfels TX 78130-3689 Ph: (830) 730-4194 |
| NPI Number | 1902414402 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 05/25/2023 |
| Certification Date | 05/25/2023 |
| Medicare PECOS PAC ID | 1456770759 |
|---|---|
| Medicare Enrollment ID | O20201007000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902414402 | NPI | - | NPPES |
| Provider Name | Ho Sung Sung Pak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518025766 PECOS PAC ID: 1759313794 Enrollment ID: I20050915000404 |
| Provider Name | Sandra L French |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700946696 PECOS PAC ID: 8921009333 Enrollment ID: I20180419000024 |
| Provider Name | Mallory Antoinette Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124406475 PECOS PAC ID: 1456786193 Enrollment ID: I20200127001489 |
| Provider Name | Ashley M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063194009 PECOS PAC ID: 1759737919 Enrollment ID: I20231024001779 |
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