MEDICARE: HEALTH AND HUMAN SERVICES COMMISSION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	103TC0700X	Clinical Psychologist	TX
2	183500000X	Pharmacist	TX
3	2084F0202X	Forensic Psychiatry Physician	TX
4	2084N0400X	Neurology Physician	TX
5	2084P0800X	Psychiatry Physician	TX
6	2084P0804X	Child & Adolescent Psychiatry Physician	TX
7	2084P0805X	Geriatric Psychiatry Physician	TX
8	208D00000X	General Practice Physician	TX
9	283Q00000X	Psychiatric Hospital
10	363A00000X	Physician Assistant	TX
11	363L00000X	Nurse Practitioner	TX
12	364S00000X	Clinical Nurse Specialist	TX
13	103T00000X	Psychologist	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	HH3015	OTHER	TX	BCBS DRUG/ALCOHOL
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4589012	OTHER	TX	PHARMACY NCPDP NUMBER
7	HH4763	OTHER	TX	BCBS PSYCHIATRIC
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811907983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH AND HUMAN SERVICES COMMISSION

Provider Business Mailing Address
First Line	:	701 W 51ST ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-2312
Country	:	US
Telephone Number	:	512-438-5618
Fax Number	:	512-438-4220

Provider Business Practice Location Address
First Line	:	6711 S NEW BRAUNFELS AVENUE
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3005
Country	:	US
Telephone Number	:	210-531-7805
Fax Number	:	210-531-7796

Authorized Official
Title or Position	:	ASSOCIATE COMMISSIONER
Name	:	KRISTY CARR
Credential	:
Telephone Number	:	512-814-9642

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	02/22/2024

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