Healthcare Provider Details

I. General information

NPI: 1437371051
Provider Name (Legal Business Name): KARLA ANN KUUSISTO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7703 NORTH LAMAR BLVD. SUITE 300
AUSTIN TX
78752
US

IV. Provider business mailing address

7703 NORTH LAMAR BLVD. SUITE 300
AUSTIN TX
78752
US

V. Phone/Fax

Practice location:
  • Phone: 512-206-4213
  • Fax: 512-206-4286
Mailing address:
  • Phone: 512-206-4213
  • Fax: 512-206-4286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number161618-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1021315
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberM8106
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: