DR. JESUS BOTELLO PH.D. NPI 1386117539

NPI Information

NPI: 1386117539
Provider Name: DR. JESUS BOTELLO, PH.D.
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
8201 ROUGHRIDER DR
WINDCREST, TX
ZIP 78239
Phone: (210) 504-4786
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DR. Jesus Botello, PH.D. is a student in an organized health care education training program in Windcrest, TX. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Jesus Botello, PH.D. NPI is 1386117539. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8201 ROUGHRIDER DR
WINDCREST, TX
ZIP 78239-430
Phone: (210) 504-4786
Fax: (210) 855-8133

The enumeration date for this NPI number is 1/9/2019 and was last updated on 8/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		25320	TEXAS	No
2	390200000X	Student in an Organized Health Care Education/Training Program				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	363634201	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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