African American Mens Health Clinic
Clinic/Center, Multi-Specialty in Austin, TX. Organization (NPI-2).
NPI number1821864893
StatusActive
Last updated in NPPESNov 30, 2023
Details
- NPI
- 1821864893
- Entity type
- Organization (NPI-2)
- Legal business name
- African American Mens Health Clinic
- Organization subpart
- No
- Enumeration date
- Nov 30, 2023
- Certification date
- Nov 30, 2023
- Last updated
- Nov 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 152W00000X | Optometrist | – | – | |
| 202D00000X | Integrative Medicine | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 208D00000X | General Practice | – | – | |
| 208VP0000X | – | – | ||
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – | |
| 251B00000X | Case Management | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QP2300X | Clinic/Center, Primary Care | – | – | |
| 261QR1300X | Clinic/Center, Rural Health | – | – | |
| 103T00000X | Psychologist | – | – | |
| 104100000X | Social Worker | – | – | |
| 133V00000X | Dietitian, Registered | – | – |
Other names
- Black Men'S Health Clinic (Doing Business As)
Practice location
6633 E Highway 290 Ste 100Austin, TX 78723-1157
Phone 682-800-3163
Mailing address
6633 E Highway 290 Ste 100Austin, TX 78723-1157
Phone 682-800-3163
Authorized official
Larry Wallace
Co-Founder & Board President
6828003163
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