Healthcare Provider Details

I. General information

NPI: 1255421566
Provider Name (Legal Business Name): RAY SAENZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAY SAENZ-LARRASQUITU LCSW

II. Dates (important events)

Enumeration Date: 10/15/2006
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 LOUISIANA AVE STE 302
CORPUS CHRISTI TX
78404-2862
US

IV. Provider business mailing address

1001 LOUISIANA AVE STE 302
CORPUS CHRISTI TX
78404-2862
US

V. Phone/Fax

Practice location:
  • Phone: 361-853-9998
  • Fax: 361-855-6696
Mailing address:
  • Phone: 361-853-9998
  • Fax: 361-855-6696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10937
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10937
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: