Healthcare Provider Details

I. General information

NPI: 1083579478
Provider Name (Legal Business Name): ALTA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14135 MIDWAY RD STE G100
ADDISON TX
75001-3611
US

IV. Provider business mailing address

501 S AUSTIN AVE UNIT 1410
GEORGETOWN TX
78626-5640
US

V. Phone/Fax

Practice location:
  • Phone: 210-237-7163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE THOMASON
Title or Position: CEO
Credential: LMSW, LCDC
Phone: 737-444-1239