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General NPI Number Information
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NPI Number | 1386119972
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Entity Type | Organization
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Legal Business Name | DR. JILLIAN RACINE PLLC
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Dates
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Enumeration Date | 10/10/2018
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 8140 N MOPAC EXPY STE 3-225
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City | AUSTIN
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State | TX
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Zip | 78759-8862
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Country | US
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Telephone | 512-346-2332
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Fax | 512-346-2284
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Provider Business Mailing Address
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Address Line | 8140 N MOPAC EXPY STE 3-225
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City | AUSTIN
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State | TX
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Zip | 78759-8862
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Country | US
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Telephone | 512-346-2332
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Fax | 512-346-2284
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATHERINE SASSER
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Credential |
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Telephone | 512-346-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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