| Northwest Psychiatry Pa | |
|
11673 Jollyville Road Ste 202 Austin TX 78759-4200 | |
| (512) 342-7979 | |
| (512) 637-2596 |
| Full Name | Northwest Psychiatry Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11673 Jollyville Road, Austin, Texas |
| Authorized Official Name and Position | Arvinder Pal Singh Walia (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5123427979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Psychiatry Pa 11673 Jollyville Road Ste 202 Austin TX 78759-4200 Ph: (512) 342-7979 | Northwest Psychiatry Pa 11673 Jollyville Road Ste 202 Austin TX 78759-4200 Ph: (512) 342-7979 |
| NPI Number | 1225297344 |
|---|---|
| Provider Enumeration Date | 06/04/2008 |
| Last Update Date | 06/08/2023 |
| Certification Date | 06/08/2023 |
| Medicare PECOS PAC ID | 9436176526 |
|---|---|
| Medicare Enrollment ID | O20051027001108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225297344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mallori Weaver Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104589183 PECOS PAC ID: 5890153829 Enrollment ID: I20230622002136 |
| Provider Name | Wendy W Lowry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306311311 PECOS PAC ID: 5496113425 Enrollment ID: I20230622002318 |
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