Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Other names
Kerrville State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANA JOHNSON (ACCOUNTANT III)
(512) 206-5284
Entity
Organization
Contact information
Practice address
721 THOMPSON DRIVE, KERRVILLE, TX 78028-5154
(830) 896-2211
(830) 896-2373
Mailing address
4110 GUADALUPE ST, AUSTIN, TX 78751-4223
(512) 206-5011
(512) 206-5302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
TX
183500000X
Pharmacist
—
TX
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
2084F0202X
Forensic Psychiatry Physician
—
TX
2084P0800X
Psychiatry Physician
—
TX
2084P0804X
Child & Adolescent Psychiatry Physician
—
TX
2084P0805X
Geriatric Psychiatry Physician
—
TX
208D00000X
General Practice Physician
—
TX
363A00000X
Physician Assistant
—
TX
363L00000X
Nurse Practitioner
—
TX
364S00000X
Clinical Nurse Specialist
—
TX
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1081028-01
—
TX
05
—
1081028-02
—
TX
05
—
1273203-02
—
TX
05
—
1273203-03
—
TX
01
—
4540185
PHARMACY NCPDP NUMBER
TX
01
—
HH3002
BCBS DRUG/ALCOHOL
TX
01
—
HH4631
BCBS PSYCHIATRIC
TX
Enumeration date
08/02/2006
Last updated
08/25/2017
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