DEEP WATERS AUSTIN LLC NPI 1023534294

NPI Information

NPI: 1023534294
Provider Name: DEEP WATERS AUSTIN LLC

Other Name: JENNIFER BACA LPC

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
13740 RESEARCH BLVD STE N8
AUSTIN, TX
ZIP 78750
Phone: (512) 939-7769
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DEEP WATERS AUSTIN LLC is a mental health (including community mental health center) clinic center in Austin, TX. DEEP WATERS AUSTIN LLC NPI is 1023534294. The provider is registered as an organization entity type.
The provider Other Name Is Jennifer Baca Lpc.

The provider's business location address is:

13740 RESEARCH BLVD STE N8
AUSTIN, TX
ZIP 78750-834
Phone: (512) 939-7769
Fax: (512) 939-7769

The provider's authorized official is Jennifer Merrill Baca Davila .
The authorized official title is Member and has the following contact phone number (512) 939-7769.

The enumeration date for this NPI number is 8/18/2017 and was last updated on 8/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	71881	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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