Provider Demographics
NPI:1023712098
Name:RESURFACE GROUP OF AUSTIN PLLC
Entity type:Organization
Organization Name:RESURFACE GROUP OF AUSTIN PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:936-332-2970
Mailing Address - Street 1:2900 BRISTOL ST STE B320
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5987
Mailing Address - Country:US
Mailing Address - Phone:949-540-9729
Mailing Address - Fax:
Practice Address - Street 1:1609 NORRIS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2805
Practice Address - Country:US
Practice Address - Phone:959-540-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1801595806OtherPROVIDER NUMBER