Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Other names
Austin State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA GARNETT (PROGRAM SUPERVISOR)
(512) 913-1580
Entity
Organization
Contact information
Practice address
4110 GUADALUPE ST, AUSTIN, TX 78751-4296
(512) 419-2843
(512) 419-2683
Mailing address
4110 GUADALUPE ST, MC2023, AUSTIN, TX 78751-4223
(512) 206-5284
(512) 206-5302
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103T00000X
Psychologist
—
TX
103TC0700X
Clinical Psychologist
—
TX
183500000X
Pharmacist
—
TX
2084F0202X
Forensic Psychiatry Physician
—
TX
2084P0800X
Psychiatry Physician
—
TX
2084P0804X
Child & Adolescent Psychiatry Physician
—
TX
2084P0805X
Geriatric Psychiatry Physician
—
TX
208D00000X
General Practice Physician
—
TX
363A00000X
Physician Assistant
—
TX
363L00000X
Nurse Practitioner
—
TX
364S00000X
Clinical Nurse Specialist
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0827875-01
—
TX
05
—
0937807-01
—
TX
01
—
4539637
PHARMACY NCPDP NUMBER
TX
01
—
HH3010
BCBS DRUG/ALCOHOL
TX
01
—
HH4750
BCBS PSYCHIATRIC
TX
Enumeration date
08/02/2006
Last updated
02/22/2024
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