Healthcare Provider Details

I. General information

NPI: 1861589590
Provider Name (Legal Business Name): THOMAS B EFIRD MSW, LCSW, LCDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18911 HARDY OAK BLVD
SAN ANTONIO TX
78258-4967
US

IV. Provider business mailing address

9302 HAZELTON LN
SAN ANTONIO TX
78251-4742
US

V. Phone/Fax

Practice location:
  • Phone: 210-239-9597
  • Fax: 210-866-0202
Mailing address:
  • Phone: 210-239-9597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number61613
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: