Provider Demographics
NPI:1902067028
Name:ADHD PLUS INC
Entity Type:Organization
Organization Name:ADHD PLUS INC
Other - Org Name:ADHD PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENKAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-403-2343
Mailing Address - Street 1:1370 PANTHEON WAY STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2290
Mailing Address - Country:US
Mailing Address - Phone:210-403-2343
Mailing Address - Fax:210-403-2350
Practice Address - Street 1:1370 PANTHEON WAY
Practice Address - Street 2:STE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2290
Practice Address - Country:US
Practice Address - Phone:210-403-2343
Practice Address - Fax:210-403-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121517009Medicaid