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General NPI Number Information
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NPI Number | 1023595386
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Entity Type | Organization
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Legal Business Name | MOTION BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 6548 SPRINGFIELD AVE NUM 202
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-267-9141
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Fax | 956-290-8297
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Provider Business Mailing Address
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Address Line | 6548 SPRINGFIELD AVE NUM 202
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-267-9141
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Fax | 956-290-8297
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Authorized Official
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Title or Position | MD
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Name | MICHAEL HERNANDEZ
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Credential | MD
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Telephone | 956-267-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | L6426
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | L6426
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License Number State | TX
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