Basic Information
| Provider Information | |||||||||
| NPI: | 1356664718 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL TEXAS AUTISM CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3006 BEE CAVES RD | ||||||||
| Address2: | SUITE B200 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787465588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123285599 | ||||||||
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| Address1: | 3006 BEE CAVES RD | ||||||||
| Address2: | SUITE B200 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787465588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123285599 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2010 | ||||||||
| LastUpdateDate: | 03/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | BROWN | ||||||||
| AuthorizedOfficialFirstName: | CARA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CONSULTANT | ||||||||
| AuthorizedOfficialTelephone: | 5122961980 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BCABA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 0041386 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.