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NPI Code Detail

MEDICARE: MARIA DE LOURDES PIZANA PH.D., LPC

MEDICARE:   MARIA DE LOURDES  PIZANA  PH.D., 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
1101YM0800XMental Health Counselor11209TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
181900LOTHERTXBLUE CROSS BLUES SHIELD

General Provider Information

NPI Number : 1578673588
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA DE LOURDES PIZANA PH.D., LPC
Provider Business Mailing Address
First Line : PO BOX 12088
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-0088
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1207 BROOKLYN AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-4804
Country : US
Telephone Number : 210-472-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ MARIA DE LOURDES PIZANA PH.D., LPC” Practice Location

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