Provider Demographics
NPI:1659083780
Name:AVAZACH PSYCHIATRY SERVICES PLLC
Entity Type:Organization
Organization Name:AVAZACH PSYCHIATRY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOTTAGE-MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-282-7333
Mailing Address - Street 1:110 N INTERSTATE 35 STE 315-982
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5003
Mailing Address - Country:US
Mailing Address - Phone:512-586-3465
Mailing Address - Fax:888-200-3405
Practice Address - Street 1:110 N INTERSTATE 35 STE 315-982
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5003
Practice Address - Country:US
Practice Address - Phone:512-586-3465
Practice Address - Fax:888-200-3405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty