MEDICARE: DR. RONALD JAY ARTIS RON ARTIS, PH.D.

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	101YP2500X	Professional Counselor	10682	TX

General Provider Information

NPI Number	:	1740305382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD JAY ARTIS RON ARTIS, PH.D.

Provider Business Mailing Address
First Line	:	8502 DOROTHA CT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8111
Country	:	US
Telephone Number	:	512-795-9132
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 SPICEWOOD SPRINGS RD
Second Line	:	BLDG.4, STE.200
City	:	AUSTIN
State	:	TX
Zip	:	78759-8598
Country	:	US
Telephone Number	:	512-467-1376
Fax Number	:	512-467-8658

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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