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General NPI Number Information
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NPI Number | 1598669913
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Entity Type | Organization
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Legal Business Name | AGAVE ASSESSMENT AND THERAPY GROUP PLLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 2111 ORANGE BLOSSOM ST
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City | SAN ANTONIO
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State | TX
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Zip | 78247-4324
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Country | US
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Telephone | 214-732-2253
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR # 15935
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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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 | PSYCHOLOGIST
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Name | ERIN COGGAN
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Credential | PSYD, LP
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Telephone | 214-732-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State | NULL
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