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General NPI Number Information
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NPI Number | 1063879989
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Entity Type | Organization
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Legal Business Name | AUSTINPSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 2806 FLINTROCK TRCE STE A103
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City | AUSTIN
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State | TX
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Zip | 78738-1745
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Country | US
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Telephone | 512-584-8196
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Fax |
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Provider Business Mailing Address
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Address Line | 2806 FLINTROCK TRCE STE A103
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City | AUSTIN
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State | TX
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Zip | 78738-1745
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Country | US
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Telephone | 512-584-8196
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CARMEN L ZEGARRA
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Credential | MD
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Telephone | 512-584-8196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M8450
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License Number State | TX
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