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General NPI Number Information
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NPI Number | 1235551086
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Entity Type | Organization
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Legal Business Name | RICHARD O TEMPLE PHD PLLC
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 706B W BEN WHITE BLVD STE 120B
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City | AUSTIN
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State | TX
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Zip | 78704-7153
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Country | US
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Telephone | 512-318-1833
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Fax | 512-852-4771
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Provider Business Mailing Address
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Address Line | PO BOX 145
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-0145
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Country | US
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Telephone | 512-318-1833
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Fax | 512-852-4771
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD O TEMPLE
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Credential | PHD
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Telephone | 512-294-2304
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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 | 32760
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License Number State | TX
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