# MARY KATHLEEN BOLLES

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

## Provider details

- **NPI number:** 1760081897
- **Authorized official:** MARY KATHLEEN BOLLES PMHNP (OWNER)
- **Authorized official phone:** (512) 739-6566

## Contact information

- **Practice address:** 5000 BEE CAVES RD STE 106, WEST LAKE HILLS, TX 78746-5254
- **Practice address phone:** (512) 791-5433
- **Mailing address:** 6714 LA CONCHA PASS, AUSTIN, TX 78749-1716
- **Mailing address phone:** (512) 791-5433

## 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:** 10/20/2020
- **Last updated:** 10/20/2020