Healthcare Provider Details

I. General information

NPI: 1235551086
Provider Name (Legal Business Name): RICHARD O TEMPLE PHD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706B W BEN WHITE BLVD STE 120B
AUSTIN TX
78704-7153
US

IV. Provider business mailing address

PO BOX 145
DRIPPING SPRINGS TX
78620-0145
US

V. Phone/Fax

Practice location:
  • Phone: 512-318-1833
  • Fax: 512-852-4771
Mailing address:
  • Phone: 512-318-1833
  • Fax: 512-852-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number32760
License Number StateTX

VIII. Authorized Official

Name: DR. RICHARD O TEMPLE
Title or Position: OWNER
Credential: PHD
Phone: 512-294-2304