Provider Demographics
NPI:1134173248
Name:CENTRAL TEXAS VETERANS HEALTHCARE SYSTEM
Entity type:Organization
Organization Name:CENTRAL TEXAS VETERANS HEALTHCARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WOMEN VETERANS PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:OLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:254-743-2956
Mailing Address - Street 1:5105 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-7320
Mailing Address - Country:US
Mailing Address - Phone:254-220-9456
Mailing Address - Fax:254-743-0178
Practice Address - Street 1:5105 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-7320
Practice Address - Country:US
Practice Address - Phone:254-220-9456
Practice Address - Fax:254-743-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05387901104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty