| Water Stone Fire Darkness Pllc | |
|
3000 Polar Ln Ste 602 Cedar Park TX 78613-3073 | |
| (832) 465-0100 | |
| Not Available |
| Full Name | Water Stone Fire Darkness Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3000 Polar Ln Ste 602, Cedar Park, Texas |
| Authorized Official Name and Position | Ryan Donovan (CLINICIAN) |
| Authorized Official Contact | 8324650100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Water Stone Fire Darkness Pllc 15409 Fitzhugh Rd Dripping Springs TX 78620-5003 Ph: (832) 465-0100 | Water Stone Fire Darkness Pllc 3000 Polar Ln Ste 602 Cedar Park TX 78613-3073 Ph: (832) 465-0100 |
| NPI Number | 1427769181 |
|---|---|
| Provider Enumeration Date | 12/13/2022 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427769181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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