Gladys Cisneros, MS

Individual provider Active NPI Professional Counselor · Universal City, TX

NPI 1174072367 · NPPES record last updated Sep 28, 2016

Key facts

NPI
1174072367
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
70362 (TX)
Practice address
433 Kitty Hawk Rd
Suite 219
Universal City, TX 78148-3357
Phone
(210) 566-1280
Fax
(210) 579-8533
NPI assigned
Sep 28, 2016
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
70362TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alba Wellness Case Management LLC Past Accepting new patients
Alba Wellness Incorporated Professional Past
since May 15, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 70362 TX Yes

Addresses

Primary practice location

433 Kitty Hawk Rd
Suite 219
Universal City, TX 78148-3357

Mailing address

433 Kitty Hawk Rd
Suite 219
Universal City, TX 78148-3357
Phone (210) 566-1280

Other providers in Universal City, TX

All providers in Universal City, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.