Provider Demographics
NPI:1083941686
Name:MIRELES, HILDEBRANDO III (LPC-S)
Entity Type:Individual
Prefix:MR
First Name:HILDEBRANDO
Middle Name:
Last Name:MIRELES
Suffix:III
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11205 AMBERINA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3858
Mailing Address - Country:US
Mailing Address - Phone:830-757-0117
Mailing Address - Fax:830-757-0119
Practice Address - Street 1:1089 DEL RIO BLVD STE A
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3453
Practice Address - Country:US
Practice Address - Phone:830-757-0117
Practice Address - Fax:830-757-0119
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65437101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional