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General NPI Number Information
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NPI Number | 1043981020
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Entity Type | Organization
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Legal Business Name | ARBOR MENTAL HEALTH & FAMILY MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 6326 SOVEREIGN ST STE 160
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City | SAN ANTONIO
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State | TX
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Zip | 78229-5177
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Country | US
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Telephone | 210-324-3619
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Fax |
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Provider Business Mailing Address
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Address Line | 6326 SOVEREIGN ST STE 160
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City | SAN ANTONIO
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State | TX
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Zip | 78229-5177
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Country | US
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Telephone | 726-208-7900
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RICHARD P DIAZ
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Credential | DNP
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Telephone | 726-208-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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