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General NPI Number Information
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NPI Number | 1639170541
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Entity Type | Organization
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Legal Business Name | SENIOR ADULTS SPECIALTY HEALTHCARE PA
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3215 STECK AVE SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78757-7566
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Country | US
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Telephone | 512-476-3556
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Fax | 512-476-0195
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Provider Business Mailing Address
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Address Line | 3215 STECK AVE SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78757-7566
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Country | US
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Telephone | 512-476-3556
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Fax | 512-476-0195
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Authorized Official
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Title or Position | OWNER
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Name | DR. JARON L WINSTON
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Credential | M.D.
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Telephone | 512-476-3556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number |
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State | TX
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