Medpsych Wellness PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MEDPSYCH WELLNESS PLLC

Practice address

5282 Medical Dr Ste 605
San Antonio, TX 78229-6114

Phone

(210) 908-6337

NPI assigned

Apr 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Edgar Samuel Medina, MDNPI 1598045981

Title

Manager

Phone

(818) 415-7968

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Edgar Samuel Medina, M.D.

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1598045981
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1447889258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19141 STONE OAK PARKWAY SUITE 104",
            "address_2": "PMB 217",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583367",
            "telephone_number": "210-908-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5282 MEDICAL DR STE 605",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296114",
            "telephone_number": "210-908-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPSYCH WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-415-7968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PLAN & PROVIDER ENUMERATION SYSTEM",
            "identifier": "1598045981",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medmark Treatment Centers of Texas, Inc.
• Medmobile LLC
• Mednef PLLC
• Medone Healthcare Services, LTD.
• Medplex Laboratories
• Guillermo Medrano del Rosal, M.D.
• Gloria Elena Medrano Padilla
• Gabriel A. Medrano Valle, MD
• Amelia Oranday Medrano, CHW
• Ashley Renee Medrano, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.