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13740 Research Blvd Ste N8 Austin TX 78750-1834 | |
| (512) 939-7769 | |
| (512) 939-7769 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 13740 Research Blvd Ste N8, Austin, Texas |
| Authorized Official Name and Position | Jennifer Merrill Baca Davila (MEMBER) |
| Authorized Official Contact | 5129397769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
312 Brentwood Dr Leander TX 78641-9431 Ph: (512) 939-7769 | 13740 Research Blvd Ste N8 Austin TX 78750-1834 Ph: (512) 939-7769 |
| NPI Number | 1023534294 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 08/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023534294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 71881 (Texas) | Primary |
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