| Eye Of The Heart, Pa | |
|
4403 Manchaca Rd Suite D Austin TX 78745-1680 | |
| (512) 297-8717 | |
| (888) 395-2986 |
| Full Name | Eye Of The Heart, Pa |
|---|---|
| Speciality | Social Worker |
| Location | 4403 Manchaca Rd, Austin, Texas |
| Authorized Official Name and Position | Alisa Monique Carr (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5122978717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eye Of The Heart, Pa 4403 Manchaca Rd Suite D Austin TX 78745-1680 Ph: (512) 297-8717 | Eye Of The Heart, Pa 4403 Manchaca Rd Suite D Austin TX 78745-1680 Ph: (512) 297-8717 |
| NPI Number | 1174898910 |
|---|---|
| Provider Enumeration Date | 03/13/2012 |
| Last Update Date | 11/04/2014 |
| Medicare PECOS PAC ID | 7214191915 |
|---|---|
| Medicare Enrollment ID | O20120608000412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174898910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 27129 (Texas) | Primary |
| Provider Name | Alisa M Carr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457451114 PECOS PAC ID: 5597667634 Enrollment ID: I20040121000328 |
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