Healthcare Provider Details

I. General information

NPI: 1396037594
Provider Name (Legal Business Name): SOUTH TEXAS RURAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 MEDICAL DR
PEARSALL TX
78061-6624
US

IV. Provider business mailing address

158 MEDICAL DR
PEARSALL TX
78061-6624
US

V. Phone/Fax

Practice location:
  • Phone: 830-334-2087
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number67761
License Number StateTX

VIII. Authorized Official

Name: MS. MYRTA GARCIA
Title or Position: LICENSED PROFESSIONAL COUNSELOR I
Credential:
Phone: 830-879-3047