Organization · NPI-2

Baylor Scott And White

Clinic/Center, Mental Health (Including Community Mental Health Center) · Round Rock, TX

NPI number1063871408
StatusActive
Last updated in NPPESFeb 13, 2016

Details

NPI
1063871408
Entity type
Organization (NPI-2)
Legal business name
Baylor Scott And White
Organization subpart
No
Enumeration date
Feb 13, 2016
Last updated
Feb 13, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

425 University Blvd
Round Rock, TX 78665-1053

Phone 615-347-3845

Mailing address

200 River Oaks Cv Apt 1130
Georgetown, TX 78626-5575

Phone 615-347-3845

Authorized official

Kendra Rosse
Senior Supervisor, Clinic Operatio
5125090289

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