MEDICARE: MICHELLE DORIS RUIZ DEAL 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	101YM0800X	Mental Health Counselor	77004	TX

General Provider Information

NPI Number	:	1598231037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE DORIS RUIZ DEAL LPC

Provider Business Mailing Address
First Line	:	7800 W IH 10 STE 130
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-4765
Country	:	US
Telephone Number	:	210-622-2877
Fax Number	:	210-641-5805

Provider Business Practice Location Address
First Line	:	7800 W IH 10 STE 130
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-4765
Country	:	US
Telephone Number	:	210-622-2877
Fax Number	:	210-641-5805

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

Provider Enumeration Date	:	10/23/2018
Last Update Date	:	10/13/2025

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