Healthcare Provider Details

I. General information

NPI: 1982945879
Provider Name (Legal Business Name): ARTHUR E FREYRE III LPC , PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2013
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10807 PERN BETL RD STE 300
SAN ANTONIO TX
78217-3144
US

IV. Provider business mailing address

10807 PERRIN BEITEL RD STE 300
SAN ANTONIO TX
78217-3144
US

V. Phone/Fax

Practice location:
  • Phone: 210-245-7862
  • Fax: 210-245-7951
Mailing address:
  • Phone: 210-245-7862
  • Fax: 210-245-7951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1111706
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number66644
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: