Provider Demographics
NPI:1649738998
Name:ARMENDARIZ, OSCAR
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:ARMENDARIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12223 LUCKEY SMT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-2328
Mailing Address - Country:US
Mailing Address - Phone:210-412-0529
Mailing Address - Fax:
Practice Address - Street 1:4201 MEDICAL DR STE 330
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5805
Practice Address - Country:US
Practice Address - Phone:210-614-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73663101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health