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General NPI Number Information
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NPI Number | 1932923737
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Entity Type | Organization
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Legal Business Name | OASIS ON THE CONCHO, PLLC
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 3131 EXECUTIVE DR
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City | SAN ANGELO
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State | TX
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Zip | 76904-6801
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Country | US
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Telephone | 325-947-5021
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Fax | 325-267-2629
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Provider Business Mailing Address
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Address Line | 3221 OAK MOUNTAIN TRL
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City | SAN ANGELO
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State | TX
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Zip | 76904-7327
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Country | US
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Telephone | 325-212-9115
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | LANI ANNETTE WEBSTER
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Credential | LPC
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Telephone | 325-212-9115
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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 |
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License Number State |
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