| Live Oak Psychiatric And Family Practice, Pllc | |
|
1100 Nw Loop 410 San Antonio TX 78213-2263 | |
| (347) 607-9126 | |
| Not Available |
| Full Name | Live Oak Psychiatric And Family Practice, Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1100 Nw Loop 410, San Antonio, Texas |
| Authorized Official Name and Position | Nakeitra Curtis (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2544661749 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Psychiatric And Family Practice, Pllc 11230 Forest Pass Ct Live Oak TX 78233-7236 Ph: () - | Live Oak Psychiatric And Family Practice, Pllc 1100 Nw Loop 410 San Antonio TX 78213-2263 Ph: (347) 607-9126 |
| NPI Number | 1003579913 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 01/13/2022 |
| Medicare PECOS PAC ID | 7214327543 |
|---|---|
| Medicare Enrollment ID | O20211201000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003579913 | NPI | - | NPPES |
| Provider Name | Olanike Katibi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063712081 PECOS PAC ID: 1153677794 Enrollment ID: I20180711003553 |
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