Trauma Detox PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TRAUMA DETOX PLLC

Practice address

3613 Williams Dr Ste 1006
Georgetown, TX 78628-1376

Phone

(512) 796-5059

NPI assigned

Jul 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Danielle West

Title

Managing Partner

Phone

(512) 796-5059

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1043862246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 1006",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 1006",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281376",
            "telephone_number": "512-796-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA DETOX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "512-796-5059"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenny-Bao Tran, MD
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• Tranquility Hospice Care, Inc.
• Stephen Tranter, D.C.
• Trauma and the Art of Healing PLLC
• Travis Pathology Associates PA
• Justin Robert Traxler, DPT
• Anyssa Trejo, PMHNP-BC
• Rogelio Trevino, MD
• Trinity Balanced Family Healthcare LLC

• Professional Counselor in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.