Organization
CENTRAL TEXAS GERIATRIC BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH SLADE BOSARGE PH.D (CEO)
(512) 680-3013
Entity
Organization
Contact information
Practice address
2504 RAE DELL AVE, AUSTIN, TX 78704-4735
(512) 284-3712
(855) 700-9866
Mailing address
2504 RAE DELL AVE, AUSTIN, TX 78704-4735
(512) 284-3712
(855) 700-9866
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34161
TX
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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