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General NPI Number Information
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NPI Number | 1891044285
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Entity Type | Organization
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Legal Business Name | ANDREW D. REICHERT, PHD, PLLC
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 208 W 10TH ST SUITE 201
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City | GEORGETOWN
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State | TX
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Zip | 78626-5814
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Country | US
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Telephone | 210-708-5909
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6482
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City | SAN ANTONIO
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State | TX
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Zip | 78209-0482
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Country | US
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Telephone | 210-708-5909
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ANDREW D. REICHERT
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Credential | PHD
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Telephone | 210-708-5909
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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 | 35148
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License Number State | TX
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