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General NPI Number Information
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NPI Number | 1720884067
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Entity Type | Individual
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Provider Name | GREGORY THOMAS TEMPLE LCDC
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Gender | Male
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2015 NE LOOP 410
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5411
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Country | US
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Telephone | 210-291-6426
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Fax |
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Provider Business Mailing Address
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Address Line | 1938 E SONTERRA BLVD APT 1151
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City | SAN ANTONIO
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State | TX
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Zip | 78259-7653
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Country | US
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Telephone | 830-743-8338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17202
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License Number State | TX
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