Provider Demographics
NPI:1538306519
Name:AUSTIN, HISE CARROLL II
Entity Type:Individual
Prefix:MR
First Name:HISE
Middle Name:CARROLL
Last Name:AUSTIN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5734 TIDEWATER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085-3362
Mailing Address - Country:US
Mailing Address - Phone:713-899-7076
Mailing Address - Fax:713-283-5192
Practice Address - Street 1:5734 TIDEWATER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-3362
Practice Address - Country:US
Practice Address - Phone:713-899-7076
Practice Address - Fax:713-283-5192
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health