Camino Real Community MHMR Center
Organization Active NPI Case Management Agency · Lytle, TX
NPI 1154411262 · NPPES record last updated Mar 19, 2026
Key facts
- NPI
- 1154411262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Management Agency 251B00000X
- Legal business name
- CAMINO REAL COMMUNITY MHMR CENTER
- Practice address
- 19965 FM 3175
Lytle, TX 78052-3481 - Phone
- (210) 357-0300
- Fax
- (855) 240-1374
- NPI assigned
- Oct 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Andrea Corona
- Title
- Reimbursement/Credentialing Spec
- Phone
- (210) 357-0369
Practitioners 171
-
Daniel Bustillos, DNP, PMHNP-BC
-
Priscilla Mia Caballero, LCDC
-
Stephen Dai, M.D.
-
Sandra Kay Fleming, LPCS
-
Delia Sanchez Patino, APRN, PMHNP-BC
-
Hayden Ruiz, RN
-
Carla J Sikkema, PMHNP
-
Jacinto Robert Ybarra, LCSW
-
Katherine Chapel, MD
-
Marketa Danyalle Smith, ARNP
-
Rebecca Castro, M.D.
-
Seema Susan Varghees, M.D.
-
Marcelo Villarreal, M.D.
-
Delwin Williams, MD
-
Sam Lowy, MD
-
Ferdinand Akoko, APRN
-
Antoun Y Antoun, LPC
-
Jamon Blood, DO
-
Cassandra Boduch, MD
-
John J Byun, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614001095 | TX | Part B Supplier - Clinic/Group Practice | 9931183449 |
Receives reassigned benefits from 155 practitioners Practice locations: Floresville, TX; Pearsall, TX; Lytle, TX; Kenedy, TX; Jourdanton, TX; Eagle Pass, TX; Crystal City, TX |
National Provider Directory
Locations
315 N 1st Ave
Crystal City, TX 78839
Phone (830) 374-5854
415 W Zavala St
Crystal City, TX 78839
Phone (830) 374-5854
2644 Encino Park
Eagle Pass, TX 78852
Phone (830) 498-2030
490 S Bibb Ave
Eagle Pass, TX 78852
Phone (830) 773-5696
470 Jefferson St
Eagle Pass, TX 78852
Phone (210) 357-0300
757 E Rio Grande St
Eagle Pass, TX 78852
Phone (830) 773-5696
1005 B St
Floresville, TX 78114
Phone (830) 216-4326
1327 3rd St
Floresville, TX 78114
Phone (830) 216-2004
1749 E State Highway 97
Jourdanton, TX 78026
Phone (830) 767-2320
322 W Main St
Ste 104
Kenedy, TX 78119
Phone (830) 583-9777
221 W Main St
Kenedy, TX 78119
Phone (830) 583-9977
411 E Brazos St
Pearsall, TX 78061
Phone (830) 334-0075
404 S Pecan St
Pearsall, TX 78061
Phone (830) 334-0075
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
19965 FM 3175
Lytle, TX 78052-3481
Mailing address
PO Box 725
Lytle, TX 78052-0725
Phone (210) 357-0300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121990904 | Medicaid | TX |
Other names
- Camino Real Community Services
Other providers in Lytle, TX
- Larry Wayne Bohmfalk
- Karla Elizabeth Bowman
- Maria Louise Brochu
- Fahimah Yazdanfard Callahan
- Camino Real Community MHMR Center
- Camino Real Community MHMR Center
- Camino Real Community MHMR Center
- Camino Real Community MHMR Center
- Camino Real Community MHMR Center
- Camino Real Community MHMR Center
All providers in Lytle, TX · Case Management Agency in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.