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NPI Code Detail

MEDICARE: MS. TERESA VASQUEZ SERNA LPC

MEDICARE: MS. TERESA VASQUEZ SERNA LPC
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
1101YP2500XProfessional Counselor71879TX

General Provider Information

NPI Number : 1114436813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERESA VASQUEZ SERNA LPC
Provider Business Mailing Address
First Line : 7308 GEORGE BURNS ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-2325
Country : US
Telephone Number : 210-789-4605
Fax Number :
Provider Business Practice Location Address
First Line : 4813 FREDERICKSBURG RD STE 102B
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3666
Country : US
Telephone Number : 210-789-4605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2017
Last Update Date : 03/22/2019

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