Organization
DEPT OF ASSISTIVE & REHAB SERV - BRYAN FIELD OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH PAYNE (PROGRAM MANAGER)
(512) 424-4092
Entity
Organization
Contact information
Practice address
1115 WELSH AVE STE A, COLLEGE STATION, TX 77840-4264
(979) 680-5290
Mailing address
PO BOX 12866, AUSTIN, TX 78711-2866
(512) 377-0584
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140137405
TEXAS PROVIDER ID
TX
Enumeration date
03/13/2007
Last updated
08/08/2008
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