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General NPI Number Information
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NPI Number | 1912081761
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Entity Type | Individual
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Provider Name | GORDON HUDSON MSW LPC PHD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 325 E SONTERRA BLVD STE. #230
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4054
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Country | US
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Telephone | 210-545-6860
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Fax | 210-545-6869
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Provider Business Mailing Address
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Address Line | 325 E SONTERRA BLVD STE. #230
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4054
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Country | US
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Telephone | 210-545-6860
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Fax | 210-545-6869
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001236-042307
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 8296
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License Number State | TX
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