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NPI Code Detail

MEDICARE: TINA M GENTSCH LPC

MEDICARE: TINA M GENTSCH 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 Counselor61724TX

Other Identifiers

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

General Provider Information

NPI Number : 1588797591
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA M GENTSCH LPC
Provider Business Mailing Address
First Line : 5934 S STAPLES ST STE 230
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3800
Country : US
Telephone Number : 361-985-1541
Fax Number : 361-985-0001
Provider Business Practice Location Address
First Line : 5934 S STAPLES ST STE 230
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3800
Country : US
Telephone Number : 361-985-1541
Fax Number : 361-985-0001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/19/2010

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