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NPI Code Detail

MEDICARE: DEPARTMENT OF STATE HEALTH SERVICES

MEDICARE: DEPARTMENT OF STATE HEALTH SERVICES
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
1251K00000XPublic Health or Welfare Agency

General Provider Information

NPI Number : 1295765469
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEPARTMENT OF STATE HEALTH SERVICES
Provider Business Mailing Address
First Line : 1100 W 49TH ST
Second Line : MAIL CODE 1917, ROOM G-109
City : AUSTIN
State : TX
Zip : 78756-3101
Country : US
Telephone Number : 512-458-7111
Fax Number : 512-458-7588
Provider Business Practice Location Address
First Line : 1100 W 49TH ST
Second Line : MAIL CODE 1917, ROOM G-109
City : AUSTIN
State : TX
Zip : 78756-3101
Country : US
Telephone Number : 512-458-7111
Fax Number : 512-458-7588
Authorized Official
Title or Position : BILLING BRANCH MANAGER
Name : MS. BARBARA SUZANNE KELLY-KING
Credential :
Telephone Number : 512-458-7111
Provider Enumeration Date : 07/04/2006
Last Update Date : 08/22/2020

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Directions to “DEPARTMENT OF STATE HEALTH SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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