MEDICARE: ANNETTE SEGURA LPC-S

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	68312	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	:	1699111823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE SEGURA LPC-S

Provider Business Mailing Address
First Line	:	110 W RANDOL MILL RD
Second Line	:	SUITE 236
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4611
Country	:	US
Telephone Number	:	682-207-8313
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 W RANDOL MILL RD
Second Line	:	SUITE 236
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4611
Country	:	US
Telephone Number	:	682-207-8313
Fax Number	:

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

Provider Enumeration Date	:	05/14/2013
Last Update Date	:	07/15/2016

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