MEDICARE: MIGUEL SERRANO 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	101YP2500X	Professional Counselor	11008	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396789566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL SERRANO LPC

Provider Business Mailing Address
First Line	:	9019 SWINBURNE CT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3637
Country	:	US
Telephone Number	:	210-248-6618
Fax Number	:

Provider Business Practice Location Address
First Line	:	9019 SWINBURNE CT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3637
Country	:	US
Telephone Number	:	210-248-6618
Fax Number	:	210-745-1935

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	08/24/2009

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Directions to “ MIGUEL SERRANO LPC” Practice Location

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