MEDICARE: PATRICK JAMES WADE TRUE 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
1	101Y00000X	Counselor	69109	TX
2	171M00000X	Case Manager/Care Coordinator	69109	TX

General Provider Information

NPI Number	:	1316384522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK JAMES WADE TRUE LPC

Provider Business Mailing Address
First Line	:	1030 GRUENE SPG
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-2493
Country	:	US
Telephone Number	:	210-993-4176
Fax Number	:

Provider Business Practice Location Address
First Line	:	8626 TESORO DR STE 700
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-6234
Country	:	US
Telephone Number	:	210-993-4176
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2013
Last Update Date	:	02/05/2024

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