AUSTIN PSYCHIATRIC CLINIC, PA (NPI# 1124563754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124563754 |
| Entity Type | Organization |
| Organization Name | AUSTIN PSYCHIATRIC CLINIC, PA |
| Practice Address |
1600 W 38th St Suite 421 Austin TX 78731-6400 |
| Practice Telephone | 5124079440 |
| Practice Fax Number | 5124079448 |
| Mailing Telephone | 5124079440 |
| Mailing Fax Number | 5124079448 |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |
| Authorized Official Name | DR. BLAYNE HARRIS (PRESIDENT) |
| Authorized Official Telephone | 5124079440 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Q0763 | TX | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Q0763 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1600 W 38TH ST SUITE 421 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78731-6400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720087331 | Kristen Katherine Ude | Chiropractor | 1600 W 38th St, Suite 412, Austin, TX 78731-6400 | 2005-07-15 |
| 1700344264 | Jane Comer Crockard | Physician Assistant | 1600 W 38th St, Austin, TX 78731-6400 | 2019-03-04 |
| 1114408242 | Excelsior Pain Management Pllc | Anesthesiology | 1600 W 38th St, Austin, TX 78731 | 2018-08-27 |
| 1396224549 | Kelly Skiles | Physician Assistant | 1600 W 38th St, Austin, TX 78731-6400 | 2018-08-08 |
| 1316487911 | Andrew Collentro | Physical Therapist | 1600 W 38th St, Ste 201, Austin, TX 78731-6400 | 2017-03-01 |
| 1225576093 | Kathy Chung Marquez | Physician Assistant | 1600 W 38th St, Suite 200, Austin, TX 78731-6400 | 2017-02-01 |
| 1962948158 | Thomajan Foot Care Pa | Podiatrist | 1600 W 38th St, Suite 318, Austin, TX 78731-6400 | 2017-01-11 |
| 1942757240 | U S Anesthesia Partners of Texas | Anesthesiology | 1600 W 38th St, Suite 306, Austin, TX 78731-6400 | 2016-09-02 |
| 1356707608 | Amber Bullis | Massage Therapist | 1600 W 38th St, Suite 120, Austin, TX 78731-6400 | 2015-12-31 |
| 1043698012 | Andrea Turnipseed | Social Worker | 1600 W 38th St, Suite 404, Austin, TX 78731-6400 | 2015-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710892 | Anew Era Tms & Psychiatry of Texas, Pa | Psychiatry & Neurology | 7514 N Mopac Expressway, Suite 100, Austin, TX 78731 | 2020-11-06 |
| 1962016519 | Jennie Rose Posey | Clinical Nurse Specialist | 6500 N. Mopac Expressway, Building 3, Suite 200, Austin, TX 78731 | 2020-09-01 |
| 1437772373 | Sharon Polackal | Student in an Organized Health Care Education/Training Program | Shoal Creek Hospital, 3501 Mills Avenue, 6th Floor, Austin, TX 78731 | 2020-05-27 |
| 1699309773 | Modern Vision Group, Pllc | Optometrist | 3908 Far W Blvd, Austin, TX 78731 | 2020-02-27 |
| 1235699562 | Catherine Kerrigan | Social Worker | 7514 N Mopac Expy, Suite 100, Austin, TX 78731 | 2019-03-22 |
| 1912474651 | Austin Dental Spa, Pllc | Dentist | 3305 Northland Ste 515, Austin, TX 78731 | 2018-10-31 |
| 1982110938 | Lindsey Sheppard | Dietitian, Registered | 7000 N Mopac Expy, Suite 200, Austin, TX 78731 | 2017-12-28 |
| 1144746066 | Sarah Cotton | Occupational Therapist | 3520 Executive Center Drive, Suite 128, Austin, TX 78731 | 2017-08-22 |
| 1699299792 | Avoia Mia Tapia | Physical Therapist | 3721 Executive Center Drive, Suite 201, Austin, TX 78731 | 2017-07-31 |
| 1265889745 | Home Focus Aba | Behavioral Analyst | 6804 Capital of Tx Hwy N 412, Austin, TX 78731 | 2016-05-16 |
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| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902215098 | Iris Telehealth Medical Group Pa | Psychiatry & Neurology | 114 W 7th St Ste 650, Austin, TX 78701-3039 | 2014-08-04 |
| 1275899833 | Matthew Mceachern | Psychiatry & Neurology | 114 W 7th St Ste 900, Austin, TX 78701-3013 | 2012-04-09 |
| 1396976668 | Laurie Katherine Seremetis | Psychiatry & Neurology | 1016 Shelley Ave, Austin, TX 78703-4839 | 2009-08-04 |
| 1861655540 | Katrijn Seynnaeve Wilson | Psychiatry & Neurology | 5424 W Highway 290 Ste 108, Austin, TX 78735-8827 | 2008-07-03 |
| 1487702684 | Jay Alan Davis, Md | Psychiatry & Neurology | 202 Ashworth Dr, Austin, TX 78746-4604 | 2007-01-07 |
| 1548343254 | James Bayliss | Psychiatry & Neurology | 4110 Guadalupe St., Attn. Reimbursement Dept., Austin, TX 78751-4296 | 2006-10-24 |
| 1871674572 | Randall Mcintyre | Psychiatry & Neurology | 3160 Bee Cave Rd, Suite 201, Austin, TX 78746-5802 | 2006-10-18 |
| 1184665648 | Frank S. Floca | Psychiatry & Neurology | 1007 Mo Pac Cir Ste 203, Austin, TX 78746-6864 | 2006-06-08 |
| 1215933015 | James H Grubbs | Psychiatry & Neurology | 210 Lee Barton Dr, #318, Austin, TX 78704-1045 | 2005-06-27 |
| 1487650156 | James G Baker | Psychiatry & Neurology | Dell Medical School Dept of Psychiatry, 1701 Trinity, Austin, TX 78712 | 2005-06-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.