# GLC WELLNESS CENTER AUSTIN

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

## Provider details

- **NPI number:** 1639788243
- **Authorized official:** MR. COLLINS WATTS HARRIS IV (CEO)
- **Authorized official phone:** (816) 419-5756

## Contact information

- **Practice address:** 3781 PARADISE HILLS DR APT 29201, EULESS, TX 76040-2413
- **Practice address phone:** (816) 419-5756
- **Mailing address:** 3781 PARADISE HILLS DR APT 29201, EULESS, TX 76040-2413
- **Mailing address phone:** (816) 419-5756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2020
- **Last updated:** 06/04/2022