Healthcare Provider Details

I. General information

NPI: 1003061128
Provider Name (Legal Business Name): KEVIN MCFARLEY, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 BEE CAVES RD.
AUSTIN TX
78746
US

IV. Provider business mailing address

3421 BEE CAVES RD.
AUSTIN TX
78746
US

V. Phone/Fax

Practice location:
  • Phone: 512-328-2875
  • Fax: 512-328-1924
Mailing address:
  • Phone: 512-328-2875
  • Fax: 512-328-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number30639
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2-4328
License Number StateTX

VIII. Authorized Official

Name: MR. KEVIN MICHAEL MCFARLEY
Title or Position: OWNER
Credential:
Phone: 512-328-2875