Organization
AUSTIN MIND AND BEHAVIORAL HEALTH, LLC
Active
Other names
Austin Mind and Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD AMJADULLAH KHAN MD (MANAGER)
(512) 903-6173
Entity
Organization
Contact information
Practice address
11673 JOLLYVILLE RD STE 201, AUSTIN, TX 78759-4211
(512) 903-6173
Mailing address
11673 JOLLYVILLE RD STE 201, AUSTIN, TX 78759-4211
(512) 903-6173
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12032352
CAQH
—
Enumeration date
04/07/2019
Last updated
04/07/2019
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