Basic Information
| Provider Information | |||||||||
| NPI: | 1669110730 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANGWUNG | ||||||||
| FirstName: | PISINEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7526 LOUIS PASTEUR DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104509000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7526 LOUIS PASTEUR DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104506450 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2022 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 80495 | TX | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 80495 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.