Healthcare Provider Details

I. General information

NPI: 1902067028
Provider Name (Legal Business Name): ADHD PLUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 PANTHEON WAY STE 250
SAN ANTONIO TX
78232-2290
US

IV. Provider business mailing address

1370 PANTHEON WAY STE 250
SAN ANTONIO TX
78232-2290
US

V. Phone/Fax

Practice location:
  • Phone: 210-403-2343
  • Fax: 210-403-2350
Mailing address:
  • Phone: 210-403-2343
  • Fax: 210-403-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JERI L PENKAVA
Title or Position: OWNER
Credential: MD
Phone: 210-403-2343