Provider Information for 1295568350
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CARL PRICE LPC, LCDC
Sex: Male
NPI: 1295568350
Last Updated: 2024-08-23
Certification Date: 2024-08-23
Certification Date: 2024-08-23
Details
| Name | Value | ||||||||||||
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| NPI | 1295568350 | ||||||||||||
| Enumeration Date | 2024-08-23 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 10402 TROTTERS BAY SAN ANTONIO, TX 78254-5926 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 10402 TROTTERS BAY SAN ANTONIO, TX 78254-5926 United States Phone: 210-570-7156 | Fax: | ||||||||||||
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