MEDICARE: CENTRAL TEXAS PSYCHOLOGICAL ASSESSMENT, PLLC

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
2	103T00000X	Psychologist

General Provider Information

NPI Number	:	1902753924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TEXAS PSYCHOLOGICAL ASSESSMENT, PLLC

Provider Business Mailing Address
First Line	:	8701 MENCHACA RD STE 202
Second Line	:	BUILDING 3, SUITE 202
City	:	AUSTIN
State	:	TX
Zip	:	78748-5383
Country	:	US
Telephone Number	:	254-300-1231
Fax Number	:

Provider Business Practice Location Address
First Line	:	8701 MENCHACA RD STE 202
Second Line	:	BUILDING 3, SUITE 202
City	:	AUSTIN
State	:	TX
Zip	:	78748-5383
Country	:	US
Telephone Number	:	254-300-1231
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINA FAY
Credential	:	PSYD
Telephone Number	:	254-300-1231

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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