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NPI Code Detail

MEDICARE: DR. BLAINE CARR PHD

MEDICARE:  DR. BLAINE  CARR  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
1103T00000XPsychologist32045TX

General Provider Information

NPI Number : 1477617355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BLAINE CARR PHD
Provider Business Mailing Address
First Line : 4131 SPICEWOOD SPRINGS RD STE C8
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8658
Country : US
Telephone Number : 512-627-3583
Fax Number : 512-692-3727
Provider Business Practice Location Address
First Line : 4131 SPICEWOOD SPRINGS RD STE C8
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8658
Country : US
Telephone Number : 512-452-0381
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 01/09/2021

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Directions to “ DR. BLAINE CARR PHD” Practice Location

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