| NPI | 1295092252 |
|---|---|
| Former Legal Business Name | MOONTOWER MENTAL WELLNESS, PLLC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM COLEMAN WEATHERBY Member/Manager 512-522-7708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N6094) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2024-05-09 |