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General NPI Number Information
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NPI Number | 1174988257
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Entity Type | Organization
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Legal Business Name | MYERS-FABIAN NEUROPSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 5716 W HIGHWAY 290 SUITE 110
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City | AUSTIN
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State | TX
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Zip | 78735-8700
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Country | US
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Telephone | 512-831-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 5716 W HIGHWAY 290 SUITE 110
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City | AUSTIN
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State | TX
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Zip | 78735-8700
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Country | US
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Telephone | 512-831-7979
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON MYERS-FABIAN
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Credential | PHD
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Telephone | 512-831-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 36885
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License Number State | TX
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