NPIMap

Organization Active NPI

South Texas Psychological Associates & Consultants, LLC

  • Psychologist
  • Windcrest, TX
National Provider Identifier
1275903569
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
25320 Issued in TX
Legal business name
SOUTH TEXAS PSYCHOLOGICAL ASSOCIATES & CONSULTANTS, LLC
Practice address
8201 Roughrider Dr
Windcrest, TX 78239-2430
Phone
(210) 504-4783
Fax
(210) 855-8133
NPI assigned
Sep 30, 2015
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Dr. Jacqueline Avila, PH.D.
Title
Psychologist
Phone
(210) 504-4783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 25320 TX Primary

Addresses

Primary practice location

8201 Roughrider Dr
Windcrest, TX 78239-2430

Mailing address

8201 Roughrider Dr
Windcrest, TX 78239-2430
Phone (210) 504-4783

Other practice location 1

8622 Oak Ledge Dr
San Antonio, TX 78217-5852
Phone (210) 504-4783

Other names 1

  • South Texas Psychological Associates Other name

National Provider Directory

National Provider Directory

Locations

506 S 7th St
Carrizo Springs, TX 78834
Phone (830) 322-7463

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1275903569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 ROUGHRIDER DR",
            "city": "WINDCREST",
            "state": "TX",
            "postal_code": "782392430",
            "telephone_number": "210-504-4783",
            "fax_number": "210-855-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 ROUGHRIDER DR",
            "city": "WINDCREST",
            "state": "TX",
            "postal_code": "782392430",
            "telephone_number": "210-504-4783",
            "fax_number": "210-855-8133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8622 Oak Ledge Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782175852",
            "country_code": "US",
            "telephone_number": "210-504-4783",
            "fax_number": "210-504-4786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH TEXAS PSYCHOLOGICAL ASSOCIATES & CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "210-504-4783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "25320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Texas Psychological Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Windcrest, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.