Healthcare Provider Details

I. General information

NPI: 1811150584
Provider Name (Legal Business Name): JEANNE NEWTON LANGSTON PHD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 SPICEWOOD SPRINGS RD STE M2
AUSTIN TX
78759-8652
US

IV. Provider business mailing address

4200 RIVER PLACE BLVD
AUSTIN TX
78730-3537
US

V. Phone/Fax

Practice location:
  • Phone: 512-217-8121
  • Fax:
Mailing address:
  • Phone: 512-217-8121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEANNE NEWTON LANGSTON
Title or Position: PRESIDENT
Credential: PHD
Phone: 512-217-8121