Providence Service Corporation of Texas

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PROVIDENCE SERVICE CORPORATION OF TEXAS

Practice address

1524 S. Ih35
Suite 210
Austin, TX 78704

Phone

(512) 343-8606

Fax

(512) 343-8620

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Tina Wier

Title

Billing Coordinator

Phone

(512) 343-8606

Specialties & licenses 1

Addresses

Other names 1

• Providence Service Corporation of Texas Former legal business name

Tax ID family

Providence Service Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Providence Service Corporation

  • Exclusive Provider Organization
  • El Paso, TX
  • NPI 1447404082
  NPD tax ID

Locations

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215007141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 S. IH35",
            "address_2": "SUITE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78704",
            "telephone_number": "512-343-8606",
            "fax_number": "512-343-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 S. IH35",
            "address_2": "SUITE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78704",
            "telephone_number": "512-343-8606",
            "fax_number": "512-343-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SERVICE CORPORATION OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIER",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "512-343-8606"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Service Corporation of Texas",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• David James Prout, LMT
• Vincent Edward Provasek, MDPHD
• Markus Miller Provence, PHD
• Providacare Medical Supply LTD
• Providacare Medical Supply LTD
• Provident Memory Care Group, LLC
• Providers 2 You, PLLC
• Providing Justice LLC
• Provista Eye Clinic
• Drew Provost, O.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Austin, TX
• Providers in Austin, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.