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NPI Code Detail

MEDICARE: CASA GRACIA

MEDICARE: CASA GRACIA
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
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1669896155
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASA GRACIA
Provider Business Mailing Address
First Line : 8305 CROSS PARK DR
Second Line :
City : AUSTIN
State : TX
Zip : 78754-5154
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8305 CROSS PARK DR
Second Line :
City : AUSTIN
State : TX
Zip : 78754-5154
Country : US
Telephone Number : 512-706-7578
Fax Number :
Authorized Official
Title or Position : SUPERINTENDENT
Name : JACQUELINE PIAR-THOMAS
Credential :
Telephone Number : 512-706-7578
Provider Enumeration Date : 02/05/2014
Last Update Date : 02/05/2014

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Directions to “CASA GRACIA ” Practice Location

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