Provider Demographics
NPI:1164555900
Name:DEPT OF ASSISTIVE & REHAB SERV - UNIVERSITY OF TEXAS AT AUSTIN
Entity Type:Organization
Organization Name:DEPT OF ASSISTIVE & REHAB SERV - UNIVERSITY OF TEXAS AT AUSTIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-424-4092
Mailing Address - Street 1:PO BOX 12866
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78711-2866
Mailing Address - Country:US
Mailing Address - Phone:512-377-0584
Mailing Address - Fax:
Practice Address - Street 1:405 W 25TH ST
Practice Address - Street 2:ROOM 7 ACADEMIC CENTER
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4823
Practice Address - Country:US
Practice Address - Phone:512-471-6693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management