Healthcare Provider Details

I. General information

NPI: 1407012057
Provider Name (Legal Business Name): ZEITGEIST WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 02/28/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5282 MEDICAL DR STE 605
SAN ANTONIO TX
78229-6114
US

IV. Provider business mailing address

5282 MEDICAL DR STE 605
SAN ANTONIO TX
78229-6114
US

V. Phone/Fax

Practice location:
  • Phone: 210-447-7373
  • Fax: 210-444-2171
Mailing address:
  • Phone: 210-447-7373
  • Fax: 210-444-2171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number28225
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA ADAMS
Title or Position: PRESIDENT
Credential:
Phone: 210-271-3630