MEDICARE: DR. CAREY SHAYNE PULVERMAN 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	103TC0700X	Clinical Psychologist	37907	TX

General Provider Information

NPI Number	:	1568947984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAREY SHAYNE PULVERMAN PHD

Provider Business Mailing Address
First Line	:	3160 BEE CAVES RD STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5591
Country	:	US
Telephone Number	:	917-208-0821
Fax Number	:	888-434-3634

Provider Business Practice Location Address
First Line	:	3160 BEE CAVES RD STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5591
Country	:	US
Telephone Number	:	917-208-0821
Fax Number	:	888-434-3634

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

Provider Enumeration Date	:	10/02/2018
Last Update Date	:	10/02/2018

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