# KOTEL ATX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083430185
- **Authorized official:** CHIMENE PEREZ (CREDENTIALING MANAGER)
- **Authorized official phone:** (904) 750-3344

## Contact information

- **Practice address:** 4201 W PARMER LN STE C175, AUSTIN, TX 78727-4161
- **Practice address phone:** (855) 204-2502
- **Mailing address:** 3001 BEE CAVES RD STE 220, AUSTIN, TX 78746-5590
- **Mailing address phone:** (512) 777-2591
- **Mailing address fax:** (512) 777-3193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/23/2024
- **Last updated:** 12/07/2024