Provider Demographics
NPI:1497141980
Name:TEJAS BEHAVIORAL HEALTH MANAGEMENT ASSN
Entity Type:Organization
Organization Name:TEJAS BEHAVIORAL HEALTH MANAGEMENT ASSN
Other - Org Name:TEJAS HEALTH MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-279-9370
Mailing Address - Street 1:893 N IH 35
Mailing Address - Street 2:STE 130
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4309
Mailing Address - Country:US
Mailing Address - Phone:512-279-9370
Mailing Address - Fax:
Practice Address - Street 1:893 N IH 35
Practice Address - Street 2:STE 130
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4309
Practice Address - Country:US
Practice Address - Phone:512-279-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No302R00000XManaged Care OrganizationsHealth Maintenance Organization