Organization
AUSTIN TRAVIS COUNTY MHMR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RUSSEL VAN NORMAN M.D. (MEDICAL DIRECTOR)
(512) 440-4021
Entity
Organization
Contact information
Practice address
1631 E 2ND ST STE D, AUSTIN, TX 78702-4491
(512) 804-3600
(512) 476-1469
Mailing address
PO BOX 3548, AUSTIN, TX 78764-3548
(512) 445-7787
(512) 440-4059
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00P336
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/27/2007
Last updated
09/11/2025
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