Individual provider Active NPI

William Mack Erwin, PH.D.

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1063562684
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20855 Issued in TX
Practice address
14815 San Pedro Ave
San Antonio, TX 78232-3708
Phone
(210) 494-1991
Fax
(210) 494-7575
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20855 TX Primary

Addresses

Primary practice location

14815 San Pedro Ave
San Antonio, TX 78232-3708

Mailing address

14815 San Pedro Ave
San Antonio, TX 78232-3708
Phone (210) 494-1991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303000190 TX Practitioner - Clinical Psychologist 9830234798 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Texas Tech University Health Science Center School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3030 Nacogdoches Rd
Suite 101
San Antonio, TX 78217-4502
Phone (210) 826-9599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20855TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Turning Points Past Accepting new patients
Turning Points PastSince Aug 8, 2003 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1063562684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14815 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323708",
            "telephone_number": "210-494-1991",
            "fax_number": "210-494-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14815 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323708",
            "telephone_number": "210-494-1991",
            "fax_number": "210-494-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "WILLIAM",
        "middle_name": "MACK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "20855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.