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Organization

PUREFYT COMMUNITY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GE'O-VANNA SMITH (CLINIC DIRECTOR)
(512) 998-5100
Entity
Organization

Contact information

Practice address
14205 N MOPAC EXY, STE. 570 PMB #565290, AUSTIN, TX 78728
(512) 775-3704
(737) 800-1011
Mailing address
708 LOREY LN, CALDWELL, TX 77836-1384
(512) 775-3704
(737) 800-1011

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TH0004X
Health Psychologist
208D00000X
General Practice Physician
208VP0000X
Pain Medicine Physician
225100000X
Physical Therapist
261QF0050X
Non-Surgical Family Planning Clinic/Center
261QI0500X
Infusion Therapy Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QP2000X
Physical Therapy Clinic/Center
261QP2400X
Prison Health Clinic/Center
261QR1300X
Rural Health Clinic/Center
364SP0812X
Community Psychiatric/Mental Health Clinical Nurse Specialist

Other

Enumeration date
10/18/2022
Last updated
11/18/2024
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