NPI 1891145595
Provident Memory Care Group, LLC
Practice location
- Address
- 11013 Signal Hill Dr, Austin, TX 78737-2834
- Phone
- (512) 637-5400
- Mailing address
- 195 S Academy Ave, New Braunfels, TX 78130-5607
Authorised official
- Name
- Michael Shawn Corzine
- Title
- Ceo
- Phone
- (830) 624-1044
Registered specialties
Alzheimer Center (Dementia Center)
Primary
Registry record
- NPI
- 1891145595
- Entity type
- Organization
- NPI issued
- 14 Jun 2016
- Record last updated
- 14 Jun 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.