| Art Full Life Austin Pllc | |
|
1101 Arrow Point Dr Ste 207 Cedar Park TX 78613-7739 | |
| (512) 636-9838 | |
| Not Available |
| Full Name | Art Full Life Austin Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1101 Arrow Point Dr Ste 207, Cedar Park, Texas |
| Authorized Official Name and Position | Alice E Green (OWNER) |
| Authorized Official Contact | 5126369838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Art Full Life Austin Pllc 1005 Little Elm Park Austin TX 78758-6712 Ph: (512) 636-9838 | Art Full Life Austin Pllc 1101 Arrow Point Dr Ste 207 Cedar Park TX 78613-7739 Ph: (512) 636-9838 |
| NPI Number | 1013452663 |
|---|---|
| Provider Enumeration Date | 01/05/2017 |
| Last Update Date | 01/05/2017 |
| Medicare PECOS PAC ID | 9638611262 |
|---|---|
| Medicare Enrollment ID | O20240611000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013452663 | NPI | - | NPPES |
| 351294901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 15229 (Texas) | Primary |
| Provider Name | Alice Elizabeth Green |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154649416 PECOS PAC ID: 1456893080 Enrollment ID: I20240611000172 |
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