Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Other names
Austin State Supported Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT SCHALCHLIN (ASSOCIATE COMMISSIONER)
(512) 438-3076
Entity
Organization
Contact information
Practice address
2203 W 35TH ST, AUSTIN, TX 78703-1203
(512) 454-4731
(512) 459-5352
Mailing address
2203 W 35TH ST, AUSTIN, TX 78703-1203
(512) 454-4731
(512) 459-5352
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
TX
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
TX
207RG0100X
Gastroenterology Physician
—
TX
207W00000X
Ophthalmology Physician
—
TX
207X00000X
Orthopaedic Surgery Physician
—
TX
207Y00000X
Otolaryngology Physician
—
TX
2084N0400X
Neurology Physician
—
TX
2084P0800X
Psychiatry Physician
—
TX
208600000X
Surgery Physician
—
TX
208D00000X
General Practice Physician
—
TX
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
TX
363L00000X
Nurse Practitioner
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000710101
—
TX
Enumeration date
10/04/2006
Last updated
11/30/2018
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