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2800 S Ih 35 Ste 215 Austin TX 78704-5700 | |
| (512) 643-8770 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2800 S Ih 35 Ste 215, Austin, Texas |
| Authorized Official Name and Position | Christopher Matthew Adams (CFAO) |
| Authorized Official Contact | 5126438770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
101 W Koenig Ln Unit 300 Austin TX 78751-1273 Ph: (512) 643-8770 | 2800 S Ih 35 Ste 215 Austin TX 78704-5700 Ph: (512) 643-8770 |
| NPI Number | 1578175576 |
|---|---|
| Provider Enumeration Date | 08/20/2020 |
| Last Update Date | 11/14/2024 |
| Certification Date | 11/14/2024 |
| Medicare PECOS PAC ID | 6002227873 |
|---|---|
| Medicare Enrollment ID | O20201130001656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578175576 | NPI | - | NPPES |
| 419954901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| Provider Name | David Philip Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487677282 PECOS PAC ID: 7719089523 Enrollment ID: I20070226000484 |
| Provider Name | Steven K Klemow |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1568668713 PECOS PAC ID: 8325138266 Enrollment ID: I20071217000153 |
| Provider Name | Suzanne H Campbell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1568527638 PECOS PAC ID: 3870646383 Enrollment ID: I20090731000214 |
| Provider Name | Ellen Simms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518343367 PECOS PAC ID: 2769783216 Enrollment ID: I20151229000685 |
| Provider Name | Risa Curtis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952691438 PECOS PAC ID: 8123279577 Enrollment ID: I20160427000787 |
| Provider Name | Heath A Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821430935 PECOS PAC ID: 8224323852 Enrollment ID: I20160829003034 |
| Provider Name | Minying Gu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912387556 PECOS PAC ID: 6305156845 Enrollment ID: I20180626002727 |
| Provider Name | Michael Cheng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154049724 PECOS PAC ID: 3971988593 Enrollment ID: I20220919001563 |
| Provider Name | Corri Leeann Fancher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033886494 PECOS PAC ID: 6406387307 Enrollment ID: I20241002003625 |
| Provider Name | Denise Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073233755 PECOS PAC ID: 2466983259 Enrollment ID: I20241003003017 |
| Provider Name | Myrto Alampanou |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538872627 PECOS PAC ID: 8820529548 Enrollment ID: I20241007000360 |
| Provider Name | Olivia-beth Horak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821876947 PECOS PAC ID: 1456883362 Enrollment ID: I20241016004911 |
| Provider Name | Sara Young |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235587213 PECOS PAC ID: 8729510599 Enrollment ID: I20241017002530 |
| Provider Name | Cynthia B Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295207033 PECOS PAC ID: 5991043507 Enrollment ID: I20241025002117 |
| Provider Name | Kenyatta Brass Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184255507 PECOS PAC ID: 7416385307 Enrollment ID: I20241029000184 |
| Provider Name | Marilyn Gabrielle Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639937121 PECOS PAC ID: 7618401811 Enrollment ID: I20241111002758 |
| Provider Name | Naomi Lynnea Burr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992923049 PECOS PAC ID: 5496067043 Enrollment ID: I20241122004186 |
| Provider Name | Dawn Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386285260 PECOS PAC ID: 1658806963 Enrollment ID: I20241122004219 |
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