Michell Alexandre Llerena

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

BP10091738 Issued in TX

Practice address

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638

Phone

(210) 997-2060

NPI assigned

Apr 11, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1003601808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "210-567-5742",
            "fax_number": "210-567-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-997-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5788 Eckhert Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782403900",
            "country_code": "US",
            "telephone_number": "210-567-5742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-5756",
            "fax_number": "210-916-5756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7400 Merton Minter St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294404",
            "country_code": "US",
            "telephone_number": "210-617-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9206 Jones Maltsberger Rd Apt 3109",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782164747",
            "country_code": "US",
            "telephone_number": "239-810-6273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4647 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294403",
            "country_code": "US",
            "telephone_number": "210-358-8145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LLERENA",
        "first_name": "MICHELL",
        "middle_name": "ALEXANDRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "BP10091738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mal21h@fsu.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5788 Eckhert Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782403900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Audrey Rayburn Lewis, AU.D
• Laura Jean Lewis, DNP, APRN, BC
• Tiffany Eunah Cho Lim, DMD
• Jared Link, PSYD, ABPP
• Forrest Douglas Littlebird II, DO, MPH, DTMH
• Wendy Dees Lobre, DDS
• Maria N Locklar, DO
• Michael Joe Francis Loida, DDS
• Tabitha Long, FNP-C
• Michelle Rae Loper, MSW, LISW, LICDC

• Psychiatry Physician in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.