Provider Demographics
NPI:1386239788
Name:SHURTZ, JOHN WILLIAM III (LCDC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:SHURTZ
Suffix:III
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7428 W MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-3010
Mailing Address - Country:US
Mailing Address - Phone:210-673-8111
Mailing Address - Fax:
Practice Address - Street 1:2553 OTTER WAY
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4111
Practice Address - Country:US
Practice Address - Phone:714-812-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16645101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)