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General NPI Number Information
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NPI Number | 1417505447
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Entity Type | Organization
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Legal Business Name | BRAIN AND BEHAVIOR, PLLC
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 4131 SPICEWOOD SPRINGS RD STE H2
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City | AUSTIN
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State | TX
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Zip | 78759-8659
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Country | US
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Telephone | 512-861-8929
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 FAR WEST BLVD STE 117 #306
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City | AUSTIN
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State | TX
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Zip | 78731-3198
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MICHAEL MILLSTONE
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Credential |
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Telephone | 512-861-8929
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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 |
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License Number State |
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