| Organization Name: | DEPARTMENT OF STATE HEALTH SERVICES |
| NPI Number: | 1043220718 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HECTOR C. BALTIERRA (TEAM LEAD) |
| Mailing Address: | 1200 E Brin Street Terrell |
| State: | TX US |
| Postal Code: | 751602938 |
| Phone Number: | 9725518826 |
| Fax Number: | 9725518513 |
| NPI Enumeration Date: | 08/08/2006 |
| NPI Last Update Date: | 04/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |