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General NPI Number Information
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NPI Number | 1861906539
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Entity Type | Individual
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Provider Name | OMAR SANDOVAL LPC
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Gender | Male
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 417 31ST ST
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City | HIDALGO
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State | TX
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Zip | 78557-3621
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Country | US
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Telephone | 956-320-7809
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Fax |
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Provider Business Mailing Address
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Address Line | 417 31ST ST
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City | HIDALGO
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State | TX
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Zip | 78557-3621
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Country | US
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Telephone | 956-320-7809
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 78354
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License Number State | TX
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