Provider Demographics
NPI:1083309702
Name:SAN ANTONIO PEDIATRIC & ADOLESCENT NEUROPSYCHOLOGY SPECIALISTS PLLC
Entity Type:Organization
Organization Name:SAN ANTONIO PEDIATRIC & ADOLESCENT NEUROPSYCHOLOGY SPECIALISTS PLLC
Other - Org Name:PEDIATRIC NEUROPSYCHOLOGY SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PEDIATRIC NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:ABREGO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP, LPC
Authorized Official - Phone:210-257-9451
Mailing Address - Street 1:7434 LOUIS PASTEUR DR STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4593
Mailing Address - Country:US
Mailing Address - Phone:210-257-9451
Mailing Address - Fax:
Practice Address - Street 1:7434 LOUIS PASTEUR DR STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4593
Practice Address - Country:US
Practice Address - Phone:210-257-9451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1457702185OtherNPI