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NPI Code Detail

MEDICARE: DR. LINDA L AUTRY PHD

MEDICARE:  DR. LINDA L AUTRY  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor11716TX

General Provider Information

NPI Number : 1215288295
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA L AUTRY PHD
Provider Business Mailing Address
First Line : 104 KELLY DR STE D
Second Line :
City : VICTORIA
State : TX
Zip : 77904-1551
Country : US
Telephone Number : 361-574-9911
Fax Number : 361-574-9985
Provider Business Practice Location Address
First Line : 104 KELLY DR STE D
Second Line :
City : VICTORIA
State : TX
Zip : 77904-1551
Country : US
Telephone Number : 361-574-9911
Fax Number : 361-574-9985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2012
Last Update Date : 10/01/2012

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Directions to “ DR. LINDA L AUTRY PHD” Practice Location

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