MEDICARE: IT'S TIME TEXAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1083567317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IT'S TIME TEXAS

Provider Business Mailing Address
First Line	:	9901 BRODIE LN STE 160
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5892
Country	:	US
Telephone Number	:	512-533-9555
Fax Number	:	512-904-7555

Provider Business Practice Location Address
First Line	:	11621 CR
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703
Country	:	US
Telephone Number	:	512-533-9555
Fax Number	:	512-904-7555

Authorized Official
Title or Position	:	SVP OF OPERATIONS
Name	:	LONNICIA MAXWELL
Credential	:
Telephone Number	:	512-533-9555

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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