MEDICARE: MR. SERGIO J. BARRIOS LCSW

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	1041C0700X	Clinical Social Worker	29933	TX

General Provider Information

NPI Number	:	1477562973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SERGIO J. BARRIOS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 90241
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78709-0241
Country	:	US
Telephone Number	:	512-785-1195
Fax Number	:	512-301-1175

Provider Business Practice Location Address
First Line	:	4201 BEE CAVE RD
Second Line	:	BLG. C SUITE 213
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6465
Country	:	US
Telephone Number	:	512-785-1195
Fax Number	:	512-301-1175

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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