| NPI | 1871667808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BUNNER Officer 512-637-5841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2023-04-18 |