Laura Ann Bredvad, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1142475 Issued in TX

Practice address

5522 Green Grove St
San Antonio, TX 78223-4204

Phone

(210) 584-8154

Fax

(214) 602-8937

NPI assigned

Nov 28, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• E P Ted Williams Mdpa

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1518190859
  NPD

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1194591545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 GREEN GROVE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782234204",
            "telephone_number": "210-584-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5522 GREEN GROVE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782234204",
            "telephone_number": "210-584-8154",
            "fax_number": "214-602-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7122 Stonewall Hl",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782561926",
            "country_code": "US",
            "telephone_number": "210-404-9696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREDVAD",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1194591545",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1142475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Breaux
• Christine Elizabeth Breazeale, PH.D.
• Sara Colleen McDaniel Breda, LPC
• Jennifer J Bredell, RN
• Robert Jay Bredt, M.D.
• Pierce Benjamin Breech, DO
• Kyle Breed
• Danita Joy Breedlove
• Brandon Lamar Bregman, MD
• Shelley Brehm, PA-C

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.