Individual provider Active NPI

Gaston A Rougeaux-Burnes, PSYD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1427429745
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37123 Issued in TX
Practice address
7272 Wurzbach Rd
Suite 706
San Antonio, TX 78240-4801
Phone
(210) 615-3483
Fax
(210) 593-9863
NPI assigned
Oct 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 37123 TX Primary

Addresses

Primary practice location

7272 Wurzbach Rd
Suite 706
San Antonio, TX 78240-4801

Mailing address

7272 Wurzbach Rd
Suite 706
San Antonio, TX 78240-4801
Phone (210) 615-3483

Other identifiers 1

IdentifierTypeStateIssuer
37123OtherTXLICENSE

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
I20151117000927 TX Practitioner - Clinical Psychologist 5092025338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37123TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stonebridge Behavioral Health, P.a. Clinical CurrentSince May 9, 2019 Accepting new patients
Deer Oaks Mental Health Associates PC Clinical Past Accepting new patients

Locations

3305 81st St
Ste H
Lubbock, TX 79423
Phone (806) 748-6400

1010 Central Pkwy S
San Antonio, TX 78232
Phone (210) 255-1499

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1427429745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 706",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3483",
            "fax_number": "210-593-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 706",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3483",
            "fax_number": "210-593-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUGEAUX-BURNES",
        "first_name": "GASTON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "37123",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.