NPIMap

Organization Active NPI

Specialty Clinic Medical Group, PLLC

  • Psychiatry Physician
  • Austin, TX
National Provider Identifier
1235535121
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SPECIALTY CLINIC MEDICAL GROUP, PLLC
Practice address
5625 Eiger Rd
Ste 215
Austin, TX 78735-8977
Phone
(512) 382-1933
Fax
(512) 777-4949
NPI assigned
Nov 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Authorized official

Name
Ms. Jacqueline Capistran
Title
Billing Manager
Phone
(512) 382-1933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5625 Eiger Rd
Ste 215
Austin, TX 78735-8977

Mailing address

4515 Seton Center Pkwy
Ste 175
Austin, TX 78759-5290
Phone (512) 382-1933

Other names 1

  • Specialty Clinic of Austin Doing business as

National Provider Directory

National Provider Directory

Locations

4515 Seton Center Pkwy
Ste 175
Austin, TX 78759
Phone (512) 256-6979

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1235535121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SETON CENTER PKWY",
            "address_2": "STE 175",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595290",
            "telephone_number": "512-382-1933",
            "fax_number": "512-777-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD",
            "address_2": "STE 215",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358977",
            "telephone_number": "512-382-1933",
            "fax_number": "512-777-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY CLINIC MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "CAPISTRAN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "512-382-1933",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Clinic of Austin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 5, 2014; 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.