| Specialty Clinic Of Austin | |
|
2217 Park Bend Dr Ste 300 Austin TX 78758-5674 | |
| (512) 382-1933 | |
| (512) 777-4949 |
| Full Name | Specialty Clinic Of Austin |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2217 Park Bend Dr Ste 300, Austin, Texas |
| Authorized Official Name and Position | Divyansu Patel (MANAGER) |
| Authorized Official Contact | 5123821933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Clinic Of Austin 2217 Park Bend Dr Ste 300 Austin TX 78758-5674 Ph: (512) 382-1933 | Specialty Clinic Of Austin 2217 Park Bend Dr Ste 300 Austin TX 78758-5674 Ph: (512) 382-1933 |
| NPI Number | 1629409909 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 03/25/2022 |
| Certification Date | 03/25/2022 |
| Medicare PECOS PAC ID | 4082017512 |
|---|---|
| Medicare Enrollment ID | O20210721003537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629409909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Texas) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Charles Sweet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164568283 PECOS PAC ID: 8123181989 Enrollment ID: I20090106000425 |
| Provider Name | Nishan D Adihetty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316130065 PECOS PAC ID: 7810076882 Enrollment ID: I20101018000499 |
| Provider Name | Divyansu Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710178702 PECOS PAC ID: 2668546771 Enrollment ID: I20101109000217 |
| Provider Name | Sitwat F Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376004556 PECOS PAC ID: 4183967961 Enrollment ID: I20230831002959 |
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