MEDICARE: OMEGA MENTAL WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1013706936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMEGA MENTAL WELLNESS

Provider Business Mailing Address
First Line	:	5900 BALCONES DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	512-318-2199
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 W WALKER AVE
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76501-1740
Country	:	US
Telephone Number	:	254-677-8874
Fax Number	:	254-677-8874

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MRS. SHANNA SAMON LOSOYA
Credential	:	PMHNP-BC
Telephone Number	:	254-677-8874

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	05/06/2025

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Directions to “OMEGA MENTAL WELLNESS ” Practice Location

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