# THE OTHER SIDE TREATMENT CENTER, PLLC

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

## Provider details

- **NPI number:** 1477062032
- **Authorized official:** ELLEN DUNCAN MD (MANAGING MEMBER)
- **Authorized official phone:** (888) 509-2306

## Contact information

- **Practice address:** 3619 PAESANOS PKWY, SHAVANO PARK, TX 78231-1253
- **Practice address phone:** (888) 509-2306
- **Mailing address:** 3619 PAESANOS PKWY, SHAVANO PARK, TX 78231-1253
- **Mailing address phone:** (888) 509-2306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | TX | Yes |
| 101YP2500X | Professional Counselor | — | TX | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 09/27/2017
- **Last updated:** 07/21/2022