MEDICARE: THOUSAND BRANCHES PROFESSIONALS FLORIDA PLLC

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	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1417811712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOUSAND BRANCHES PROFESSIONALS FLORIDA PLLC

Provider Business Mailing Address
First Line	:	1020 NE LOOP 410 STE 660
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1223
Country	:	US
Telephone Number	:	726-727-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 NE LOOP 410 STE 660
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1223
Country	:	US
Telephone Number	:	726-727-4222
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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