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Organization
THE OTHER SIDE TREATMENT CENTER, PLLC
Active
Organization
THE OTHER SIDE TREATMENT CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN DUNCAN MD (MANAGING MEMBER)
(888) 509-2306
Entity
Organization
Contact information
Practice address
3619 PAESANOS PKWY, SHAVANO PARK, TX 78231-1253
(888) 509-2306
Mailing address
3619 PAESANOS PKWY, SHAVANO PARK, TX 78231-1253
(888) 509-2306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TX
101YP2500X
Professional Counselor
—
TX
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
09/27/2017
Last updated
07/21/2022
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