MEDICARE: DR. CLIFFORD A KATZ 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
1	1223G0001X	General Practice Dentistry	8795	TX
2	103TC0700X	Clinical Psychologist	22482	TX
3	103T00000X	Psychologist	2-2482	TX

General Provider Information

NPI Number	:	1447366810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFFORD A KATZ PHD

Provider Business Mailing Address
First Line	:	10609 PORTRUSH CT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78747-1465
Country	:	US
Telephone Number	:	512-680-8449
Fax Number	:

Provider Business Practice Location Address
First Line	:	10609 PORTRUSH CT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78747-1465
Country	:	US
Telephone Number	:	512-680-8449
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	06/03/2020

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