Healthcare Provider Details

I. General information

NPI: 1295649143
Provider Name (Legal Business Name): SOUTH TEXAS MIND & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E HONDO AVE
DEVINE TX
78016-3320
US

IV. Provider business mailing address

612 E HONDO AVE
DEVINE TX
78016-3320
US

V. Phone/Fax

Practice location:
  • Phone: 830-476-7312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: HAYDEN HEATH RUIZ
Title or Position: OWNER/PMNP-BC
Credential: PMHNP-BC
Phone: 830-538-8196