Organization
CLEAR WATER PSYCHIATRY & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TORI GOLD (OFFICE MANAGER)
(512) 203-3588
Entity
Organization
Contact information
Practice address
1600 W 38TH ST STE 318, AUSTIN, TX 78731
(512) 203-3588
Mailing address
1600 W 38TH ST STE 318, AUSTIN, TX 78731-6406
(512) 203-3588
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
AP1316491368
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316491368
NPPES
TX
01
—
1669658506
NPPES
TX
01
—
AP122637
TEXAS BOARD OF NURSING
TX
01
—
AP131368
TEXAS BOARD OF NURSING
TX
Enumeration date
07/24/2018
Last updated
06/03/2019
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