MEDICARE: MS. IRENE TOBIS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist	33818	TX

General Provider Information

NPI Number	:	1033376454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRENE TOBIS PHD

Provider Business Mailing Address
First Line	:	6633 E HIGHWAY 290
Second Line	:	SUITE 300
City	:	AUSTIN
State	:	TX
Zip	:	78723-1172
Country	:	US
Telephone Number	:	512-327-9494
Fax Number	:	512-637-5578

Provider Business Practice Location Address
First Line	:	6633 E HIGHWAY 290
Second Line	:	SUITE 300
City	:	AUSTIN
State	:	TX
Zip	:	78723-1172
Country	:	US
Telephone Number	:	512-327-9494
Fax Number	:	512-637-5578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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