MEDICARE: TAO PROSPERITY COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1639833973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAO PROSPERITY COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1210 HUNT LN APT 21311
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4670
Country	:	US
Telephone Number	:	830-255-7465
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 HUNT LN APT 21311
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4670
Country	:	US
Telephone Number	:	830-255-7465
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAVID CORTEZ
Credential	:	LPC, LCDC
Telephone Number	:	830-255-7465

Provider Enumeration Date	:	10/22/2021
Last Update Date	:	10/22/2021

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