Healthcare Provider Details

I. General information

NPI: 1649084153
Provider Name (Legal Business Name): QUEST TBI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 HUEBNER RD STE 103
SAN ANTONIO TX
78230-1209
US

IV. Provider business mailing address

12000 HUEBNER RD STE 103
SAN ANTONIO TX
78230-1209
US

V. Phone/Fax

Practice location:
  • Phone: 361-332-8877
  • Fax:
Mailing address:
  • Phone: 361-332-8877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: VERONICA A JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 361-332-8877