NPIMap

Organization Active NPI

Deer Oaks Minnesota LLC

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1609158872
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DEER OAKS MINNESOTA LLC
Practice address
7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801
Phone
(210) 615-3405
Fax
(210) 593-9863
NPI assigned
Sep 14, 2011
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Mark Neese Jr.
Title
Cfo
Phone
(210) 615-3434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801

Mailing address

7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801
Phone (210) 615-3405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120119000720 MN Part B Supplier - Clinic/Group Practice 0840467684 Receives reassigned benefits from 6 practitioners
Practice locations: Mankato, MN; Willmar, MN; Litchfield, MN; Le Center, MN; Ellsworth, MN; Duluth, MN
O20211012000566 MI Part B Supplier - Clinic/Group Practice 0840467684 Receives reassigned benefits from 2 practitioners
Practice locations: Saline, MI

National Provider Directory

National Provider Directory

Locations

2501 Rice Lake Rd
Duluth, MN 55811
Phone (218) 625-6400

444 N Cordova Ave
Le Center, MN 56057
Phone (507) 357-2275

93 3Rd St E
Morgan, MN 56266
Phone (507) 249-3143

594 Cherry Dr
Waconia, MN 55387
Phone (952) 442-2546

901 Willmar Ave SE
Willmar, MN 56201
Phone (320) 214-5643

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1609158872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3405",
            "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 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-3405",
            "fax_number": "210-593-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER OAKS MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "NEESE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "210-615-3434",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.