Soba Texas LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SOBA TEXAS LLC

Doing business as

Soba Recovery Center

Practice address

1401 Dezarae, Lot 4
San Antonio, TX 78253

Phone

(210) 530-4167

NPI assigned

Jun 13, 2016

Last updated

Sep 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Audrey Graham

Title

Cfo

Phone

(310) 457-5250

Specialties & licenses 2

Addresses

Other names 1

• Soba Recovery Center Doing business as

Tax ID family

Soba Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Soba Texas LLC

  dba Soba Recovery Center

  • Substance Abuse Rehabilitation Facility
  • San Antonio, TX
  • NPI 1831520360
  NPD tax ID

Locations

Practitioners 3

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.

• Annette Marie Minner, LCDC-I

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
  • NPI 1316520687
  NPD (past)
• Shannon O'Donnell, LCSW-S, LCDC

  • Social Worker
  • San Antonio, TX
  • NPI 1376817262
  NPD (past)
• Bolanle Ojo, LCDC-I

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
  • NPI 1699407304
  NPD (past)

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1336599182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 DEZARAE",
            "address_2": "LOT 3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DEZARAE, LOT 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78253",
            "telephone_number": "210-530-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBA TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-457-5250"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soba Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Travis Walker Snyder
• Wendy Melisa Snyder, PHARM.D.
• Brian So, DO
• Mary Ey So, MSW, LMSW
• Jair Soares, M.D.
• Soba Texas LLC (Soba Recovery Center)
• Rebecca Nicole Sobalvarro, LVN
• Hezekiah Oluwarotimi Sobamowo, MD
• Kristen Sobieray-Brunner, LMFT
• Michael A Sobolevsky, DPM

• Substance Use Disorder Rehabilitation Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.