| Austin State Hospital | |
|
4110 Guadalupe St Austin TX 78751-4296 | |
| (512) 419-2843 | |
| (512) 419-2683 |
| Full Name | Austin State Hospital |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 4110 Guadalupe St, Austin, Texas |
| Authorized Official Name and Position | Linda Garnett (PROGRAM SUPERVISOR) |
| Authorized Official Contact | 5129131580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin State Hospital 4110 Guadalupe St Mc2023 Austin TX 78751-4223 Ph: (512) 206-5284 | Austin State Hospital 4110 Guadalupe St Austin TX 78751-4296 Ph: (512) 419-2843 |
| NPI Number | 1003823030 |
|---|---|
| Provider Enumeration Date | 08/02/2006 |
| Last Update Date | 02/22/2024 |
| Certification Date | 02/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003823030 | NPI | - | NPPES |
| 0937807-01 | Medicaid | TX | |
| HH3010 | Other | TX | BCBS DRUG/ALCOHOL |
| HH4750 | Other | TX | BCBS PSYCHIATRIC |
| 4539637 | Other | TX | PHARMACY NCPDP NUMBER |
| 0827875-01 | Medicaid | TX |
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