Healthcare Provider Details

I. General information

NPI: 1164134441
Provider Name (Legal Business Name): ADVANCED PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8626 TESORO DR STE 490
SAN ANTONIO TX
78217-6217
US

IV. Provider business mailing address

8626 TESORO DR STE 490
SAN ANTONIO TX
78217-6217
US

V. Phone/Fax

Practice location:
  • Phone: 210-202-0100
  • Fax:
Mailing address:
  • Phone: 210-202-0100
  • Fax: 210-579-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LORI GULLEY
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 210-906-8355