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General NPI Number Information
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NPI Number | 1104991793
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Entity Type | Organization
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Legal Business Name | ASSOCIATES FOR BEHAVIORAL HEALTH CARE PC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 609 W. 18TH ST.
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City | AUSTIN
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State | TX
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Zip | 78701-1163
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Country | US
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Telephone | 512-797-8747
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Fax | 512-491-5030
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Provider Business Mailing Address
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Address Line | PO BOX 50468
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City | AUSTIN
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State | TX
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Zip | 78763-0468
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Country | US
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Telephone | 512-797-8747
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Fax | 512-225-6344
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW BUERGER
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Credential | PHD
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Telephone | 512-797-8747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 30719
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License Number State |
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