Healthcare Provider Details

I. General information

NPI: 1689127169
Provider Name (Legal Business Name): PROVIDERS 2 YOU, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CONGRESS AVE STE 1540
AUSTIN TX
78701-3851
US

IV. Provider business mailing address

401 CONGRESS AVE STE 1540
AUSTIN TX
78701-3851
US

V. Phone/Fax

Practice location:
  • Phone: 512-900-3722
  • Fax:
Mailing address:
  • Phone: 512-900-3722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: GRIFFIN MULCAHEY
Title or Position: COO
Credential:
Phone: 512-900-3722