Provider Demographics
NPI:1740845718
Name:TOOMEY, PHILOMENA C
Entity type:Individual
Prefix:
First Name:PHILOMENA
Middle Name:C
Last Name:TOOMEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19965 FM 3175
Mailing Address - Street 2:
Mailing Address - City:LYTLE
Mailing Address - State:TX
Mailing Address - Zip Code:78052-3481
Mailing Address - Country:US
Mailing Address - Phone:210-357-0300
Mailing Address - Fax:855-240-1374
Practice Address - Street 1:1327 3RD ST
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-1961
Practice Address - Country:US
Practice Address - Phone:830-310-5300
Practice Address - Fax:830-310-5300
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11768101YA0400X
TX86651101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional