1114068491 NPI number — MRS. ASHA PATEL DEVASIA M. S., LPC, LPA

Table of content: AMANDA CHAN (NPI 1326885872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114068491 NPI number — MRS. ASHA PATEL DEVASIA M. S., LPC, LPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEVASIA
Provider First Name:
ASHA
Provider Middle Name:
PATEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M. S., LPC, LPA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114068491
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8028 WHITWORTH LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROUND ROCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78681
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-769-7511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CHISHOLM TRAIL RD STE 450
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROUND ROCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78681-5094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-763-0592
Provider Business Practice Location Address Fax Number:
877-583-4222
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  18156 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1788622 -01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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