West Texas Counselling and Rehabilitation Program of San Angelo, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

WEST TEXAS COUNSELLING AND REHABILITATION PROGRAM OF SAN ANGELO, INC.

Doing business as

WTCR San Angelo, Inc.

Practice address

601 S Irving St Ste D
San Angelo, TX 76903-6961

Phone

(325) 653-3683

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Ivan Garcia, MDNPI 1649596974

Title

President

Phone

(325) 653-3683

Specialties & licenses 2

Addresses

Other names 1

• WTCR San Angelo, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Opioid treatment program

Medicare-enrolled since Aug 23, 2020

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivan F Garcia, M.D.

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1649596974
  NPD Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1437280534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303249",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787030055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S IRVING ST STE D",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036961",
            "telephone_number": "325-653-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS COUNSELLING AND REHABILITATION PROGRAM OF SAN ANGELO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "325-653-3683",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WTCR San Angelo, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WTCR San Angelo, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Weiershausen, PNP
• Shelly Denise Weise, EDD
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• Substance Use Disorder Rehabilitation Clinic/Center in San Angelo, TX
• Providers in San Angelo, 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 Apr 29, 2021; 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.