11 11 Mission Behavioral Health PLLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Poth, TX
NPI 1255069878 · NPPES record last updated Aug 11, 2022
Key facts
- NPI
- 1255069878
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- 11 11 MISSION BEHAVIORAL HEALTH PLLC
- Practice address
- 117 Dilworth Plaza
Poth, TX 78147 - Phone
- (830) 582-8778
- NPI assigned
- Aug 11, 2022
- Organization subpart
- No
Authorized official
- Name
- Carla Sikkema
- Title
- Owner
- Phone
- (210) 722-1549
Practitioners 2
-
Carla J Sikkema, PMHNP
-
Don D Howe, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230728000166 | TX | Part B Supplier - Clinic/Group Practice | 0244691988 |
Receives reassigned benefits from 1 practitioner Practice locations: Floresville, TX |
National Provider Directory
Locations
1395 State Highway 97 E
Floresville, TX 78114
1019 B St
Floresville, TX 78114
Phone (210) 303-5825
923 10th St
Ste 123
Floresville, TX 78114
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
117 Dilworth Plaza
Poth, TX 78147
Mailing address
923 10TH St Ste 123
Floresville, TX 78114-1870
Phone (830) 582-8778
Other names
- Mission Behavioral Health
Other providers in Poth, TX
- Elizabeth A. Clancy-Hrna
- Concentra Primary Care PA
- Little Hearts Home Health LLC
- Maria D. Ponse, D.O., P.a
- Deborah K Polasek
All providers in Poth, TX · Psychiatric/Mental Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2022. 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.