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General NPI Number Information
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NPI Number | 1750062816
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Entity Type | Organization
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Legal Business Name | BRAIN TREATMENT CENTER NORTH AUSTIN, PLLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 2261 GATTIS SCHOOL RD STE 105
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City | ROUND ROCK
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State | TX
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Zip | 78664-2880
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Country | US
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Telephone | 832-880-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 2261 GATTIS SCHOOL RD STE 105
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City | ROUND ROCK
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State | TX
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Zip | 78664-2880
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Country | US
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Telephone | 832-880-5052
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MICHAEL DO
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Credential |
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Telephone | 408-887-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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