Healthcare Provider Details

I. General information

NPI: 1740442516
Provider Name (Legal Business Name): GEORGE PAZDRAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4407 BEE CAVE RD SUITE 513
WEST LAKE HILLS TX
78746-6405
US

IV. Provider business mailing address

4407 BEE CAVE RD SUITE 513
WEST LAKE HILLS TX
78746-6405
US

V. Phone/Fax

Practice location:
  • Phone: 512-328-2488
  • Fax: 512-328-3228
Mailing address:
  • Phone: 512-328-2488
  • Fax: 512-328-3228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberF1890
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberF1890
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: