Individual provider Active NPI

Gilbert Aguallo

  • Counselor
  • San Antonio, TX
National Provider Identifier
1275679151
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
13567 Issued in TX
Practice address
803 Castroville Rd
San Antonio, TX 78237-3153
Phone
(210) 436-2339
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 13567 TX Primary

Addresses

Primary practice location

803 Castroville Rd
San Antonio, TX 78237-3153

Mailing address

22931 Seeple Bluff
San Antonio, TX 78256

Other identifiers 1

IdentifierTypeStateIssuer
1335572-01MedicaidTX

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209001257 TX Practitioner - Mental Health Counselor 8123461803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evidence of Grace Counseling CenterGroup PAC ID 5496198160, 3 clinicians

Practice addresses (Care Compare)

803 Castroville Rd
Suite 134
San Antonio, TX 78237-3148
Phone (210) 436-2339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13567TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evidence of Grace Counseling Center Counselor CurrentSince Jan 10, 2024 Accepting new patients
Evidence of Grace Counseling Center Past Accepting new patients

Locations

803 Castroville Rd
Ste 134
San Antonio, TX 78237
Phone (210) 436-2339

803 Castroville Rd
San Antonio, TX 78237
Phone (210) 434-4811

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275679151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22931 SEEPLE BLUFF",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 CASTROVILLE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782373153",
            "telephone_number": "210-436-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUALLO",
        "first_name": "GILBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "13567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1335572-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.