TKT Enlightenment, LLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

M7529 Issued in TX

Legal business name

TKT ENLIGHTENMENT, LLC

Practice address

17720 Corporate Woods Dr
San Antonio, TX 78259-3500

Phone

(210) 495-3627

Fax

(210) 491-3581

NPI assigned

Feb 9, 2012

Last updated

May 25, 2012By 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

Dr. Henry Lysell Polk, M.D.NPI 1053390013

Title

Ceo

Phone

(210) 857-8301

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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.

• Henry Lysell Polk Jr., M.D.

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1053390013
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1407128218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17503 LA CANTERA PKWY",
            "address_2": "SUITE 104, #485",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782578207",
            "telephone_number": "210-857-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 CORPORATE WOODS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782593500",
            "telephone_number": "210-495-3627",
            "fax_number": "210-491-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TKT ENLIGHTENMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "LYSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-857-8301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "M7529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Joel Adlao Tiu, RN
• Patricia N Tiu, PMHNP
• Nena Tiukinhoy, FNP
• Ankur Tiwari, MBBS
• TJS Management, LLC (Holy Savior Hospice)
• Kennedy Michael Tlaseca, MD
• TLC at Home Inc
• TLC Community Living
• TLC Kid's Therapy
• TLC the Laser Center (Institute) Inc. (TLC Laser Eye Centers San Antonio)

• Child & Adolescent Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.