MEDICARE: CARLY DECKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	404902	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1051175	TX
3	163W00000X	Registered Nurse	133977	IA

General Provider Information

NPI Number	:	1902415870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY DECKER

Provider Business Mailing Address
First Line	:	1430 COLLIER ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1631 E 2ND ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-4490
Country	:	US
Telephone Number	:	512-472-4357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	12/09/2025

Similar Medicare Providers

1326842592 — SILVIA ATIM LCDC
Practice Location Address:

1631 E 2ND ST
AUSTIN, TX
78702-4490

Practice Phone: 512-804-3380
Practice Fax: 512-472-5857

1093934846 — MS. MADLYN L. WILHITE LVN
Practice Location Address:

1631 E 2ND ST
AUSTIN, TX
78702-4490

Practice Phone: 512-476-7263
Practice Fax: 512-476-1469

1548481518 — MR. SAM C. WILSON LCSW
Practice Location Address:

1631 E 2ND ST , B
AUSTIN, TX
78702-4490

Practice Phone: 512-804-3366
Practice Fax: 512-804-3672

1982895173 — DR. POLAWYN CLAIRE MCKINNEY MD
Practice Location Address:

1631 E 2ND ST , BUILDING D
AUSTIN, TX
78702-4490

Practice Phone: 512-472-4357
Practice Fax: 512-476-1469

1447562657 — ELIZABETH ANNE DOSSMAN LPC
Practice Location Address:

1631 E 2ND ST , BLDG E
AUSTIN, TX
78702-4490

Practice Phone: 512-804-3650
Practice Fax: 512-476-0217

1760823926 — SUMRE MICHELLE JENSEN LCSW
Practice Location Address:

1631 E 2ND ST
AUSTIN, TX
78702-4490

Practice Phone: 501-804-3627
Practice Fax:

Directions to “ CARLY DECKER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.