Provider Demographics
NPI:1336327626
Name:AUSTIN NEUROPSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:AUSTIN NEUROPSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-392-3398
Mailing Address - Street 1:310 STAGECOACH TRL STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5183
Mailing Address - Country:US
Mailing Address - Phone:512-392-3398
Mailing Address - Fax:512-392-2890
Practice Address - Street 1:310 STAGECOACH TRL STE 300
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5183
Practice Address - Country:US
Practice Address - Phone:512-392-3398
Practice Address - Fax:512-392-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0011LCOtherBLUE CROSS