Individual provider Active NPI

Teresita Mouret Brothers, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1093710758
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
H1049 Issued in TX
Practice address
8109 Fredericksburg Rd
San Antonio, TX 78229-3311
Phone
(210) 575-0250
Fax
(210) 575-0258
NPI assigned
Jun 17, 2005
Last updated
Jan 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X H1049 TX Primary

Addresses

Primary practice location

8109 Fredericksburg Rd
San Antonio, TX 78229-3311

Mailing address

2727 Treble CRK Apt 724
San Antonio, TX 78258-4555

Other identifiers 2

IdentifierTypeStateIssuer
8U9623OtherTXBCBS
126294109MedicaidTX

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040612000442 TX Practitioner - Psychiatry 0941283592 Practice locations: San Antonio, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H1049TXMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Inpatient Management Group Past Accepting new patients
Harlingen Physician Network Inc Child & Adolescent Psychiatry Past Accepting new patients
Lubbock Regional MHMR Center PastSince May 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pbh.teresitabrothers@136732.advancedmd-direct.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1093710758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 TREBLE CRK APT 724",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-575-0250",
            "fax_number": "210-575-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERS",
        "first_name": "TERESITA",
        "middle_name": "MOURET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "H1049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8U9623",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126294109",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.