Provider Demographics
NPI:1033294608
Name:RELIANCE BEHAVIORAL HEALTH, P.C.
Entity Type:Organization
Organization Name:RELIANCE BEHAVIORAL HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CROOK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:210-744-5863
Mailing Address - Street 1:PO BOX 690864
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78269-0864
Mailing Address - Country:US
Mailing Address - Phone:210-744-5863
Mailing Address - Fax:210-479-1959
Practice Address - Street 1:13014 KINGS FOREST ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1515
Practice Address - Country:US
Practice Address - Phone:210-744-5863
Practice Address - Fax:210-479-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX16832103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00977KMedicare ID - Type UnspecifiedMEDICARE B GROUP #