NPIMap

Organization Active NPI

Geriatric Evaluation & Mental

  • Clinical Psychologist
  • Austin, TX
National Provider Identifier
1225208200
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GERIATRIC EVALUATION & MENTAL
Practice address
4501 Dudmar Dr
Austin, TX 78735-6913
Phone
(832) 448-2800
Fax
(832) 448-2801
NPI assigned
Mar 6, 2008
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Gary Gerstenhaber
Title
Manager
Phone
(512) 301-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

4501 Dudmar Dr
Austin, TX 78735-6913

Mailing address

12012 Wickchester LN
Suite 550
Houston, TX 77079-1229
Phone (832) 448-2800

Other identifiers 1

IdentifierTypeStateIssuer
CJ2516OtherTXRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

2704 N Main St
Taylor, TX 76574
Phone (512) 365-3584

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1225208200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12012 WICKCHESTER LN",
            "address_2": "SUITE 550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770791229",
            "telephone_number": "832-448-2800",
            "fax_number": "832-448-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 DUDMAR DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356913",
            "telephone_number": "832-448-2800",
            "fax_number": "832-448-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC EVALUATION & MENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "GERSTENHABER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-301-7200"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ2516",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.