| Central Texas Geriatric Behavioral Health | |
|
2504 Rae Dell Ave Austin TX 78704-4735 | |
| (512) 284-3712 | |
| (855) 700-9866 |
| Full Name | Central Texas Geriatric Behavioral Health |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2504 Rae Dell Ave, Austin, Texas |
| Authorized Official Name and Position | Joseph Slade Bosarge (CEO) |
| Authorized Official Contact | 5126803013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Texas Geriatric Behavioral Health 2504 Rae Dell Ave Austin TX 78704-4735 Ph: (512) 284-3712 | Central Texas Geriatric Behavioral Health 2504 Rae Dell Ave Austin TX 78704-4735 Ph: (512) 284-3712 |
| NPI Number | 1316370562 |
|---|---|
| Provider Enumeration Date | 08/12/2013 |
| Last Update Date | 08/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316370562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 34161 (Texas) | Primary |
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