Mind, Body & Soul, Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

10715 Issued in TX

Legal business name

MIND, BODY & SOUL, INC.

Practice address

1139 Gembler Rd
San Antonio, TX 78219-3224

Phone

(210) 551-8244

Fax

(210) 263-9765

NPI assigned

Jun 29, 2015

Last updated

Jun 29, 2015By 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

Mr. Albert Bryan, LCDC/MSW

Title

Owner/Operator

Phone

(210) 551-8244

Specialties & licenses 1

Addresses

Tax ID family

Mind Body Soul of New Orleans Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mind,Body & Soul, Inc.

  • Community/Behavioral Health Agency
  • San Antonio, TX
  • NPI 1437515848
  NPD tax ID
• Mind, Body & Soul of New Orleans, Inc.

  • Counselor
  • Gretna, LA
  • NPI 1740443399
  NPD tax ID

Locations

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1942682737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6039 LAKEVIEW DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782441689",
            "telephone_number": "210-551-8244",
            "fax_number": "210-263-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 GEMBLER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782193224",
            "telephone_number": "210-551-8244",
            "fax_number": "210-263-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND, BODY & SOUL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "210-551-8244",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCDC/MSW"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "10715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Matters Psychiatric Clinic PLLC
• Mind Matters Psychiatric Clinic PLLC
• Mind Sight LLC (Mind Your Self)
• Mind Simplicity, PLLC
• Mind Unwind PLLC
• Mind,Body & Soul, Inc.
• Minda J Gray (Omos Park Cosmetic Dentistry)
• Mindcare Mental Wellness PLLC
• Mindful Connections of South Texas Therapy & Consulting
• Mindful Innovations Counseling Services, PLLC

• Preferred Provider Organization in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.