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General NPI Number Information
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NPI Number | 1104716836
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Entity Type | Individual
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Provider Name | ROY RIOS JR. LMSW
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Gender | Male
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Dates
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Enumeration Date | 07/04/2025
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Last Update Date | 07/04/2025
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Provider Practice Location Address
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Address Line | 2111 DICKSON DR STE 16
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City | AUSTIN
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State | TX
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Zip | 78704-4788
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Country | US
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Telephone | 512-270-8215
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 CONYERS
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City | AUSTIN
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State | TX
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Zip | 78725-3029
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Country | US
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Telephone | 512-815-1360
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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