Provider Demographics
NPI:1447317706
Name:BRIONES, ANNETTE (MEDLPC)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:BRIONES
Suffix:
Gender:F
Credentials:MEDLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 E SCHUSTER AVE
Mailing Address - Street 2:BLDG 6
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4672
Mailing Address - Country:US
Mailing Address - Phone:915-532-7799
Mailing Address - Fax:915-534-9140
Practice Address - Street 1:1201 E SCHUSTER AVE
Practice Address - Street 2:BLDG 6
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4672
Practice Address - Country:US
Practice Address - Phone:915-532-7799
Practice Address - Fax:915-534-9140
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60754101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84943LOtherBCBS TX
TX1717050Medicaid