Organization
THE OTHER SIDE TREATMENT CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN DUNCAN MD (MANAGING MEMBER)
(888) 509-2306
Entity
Organization
Contact information
Practice address
3619 PAESANOS PKWY, SHAVANO PARK, TX 78231-1253
(888) 509-2306
Mailing address
3619 PAESANOS PKWY, SHAVANO PARK, TX 78231-1253
(888) 509-2306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TX
101YP2500X
Professional Counselor
—
TX
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
09/27/2017
Last updated
07/21/2022
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