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General NPI Number Information
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NPI Number | 1902551252
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Entity Type | Organization
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Legal Business Name | GREG HUPP, PHD, PLLC
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 4413 SPICEWOOD SPRINGS RD STE 308
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City | AUSTIN
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State | TX
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Zip | 78759-8580
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Country | US
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Telephone | 512-893-6337
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 648
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City | KEMPNER
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State | TX
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Zip | 76539-0636
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Country | US
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Telephone | 512-893-6337
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GREG HUPP
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Credential | PH.D.
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Telephone | 512-893-6337
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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 |
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License Number State |
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