Healthcare Provider Details

I. General information

NPI: 1679965917
Provider Name (Legal Business Name): SPRAGGINS PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 WESTERN TRAILS BLVD STE 202
AUSTIN TX
78745-1647
US

IV. Provider business mailing address

2222 WESTERN TRAILS BLVD STE 202
AUSTIN TX
78745-1647
US

V. Phone/Fax

Practice location:
  • Phone: 512-448-3221
  • Fax: 512-448-3218
Mailing address:
  • Phone: 512-448-3221
  • Fax: 512-448-3218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA B SPRAGGINS
Title or Position: OWNER AND CHIEF CLINICIAN
Credential: PH.D
Phone: 512-448-3221