Provider Demographics
NPI:1548040298
Name:THE NEUROPSYCHOLOGICAL ASSESSMENT CLINIC OF AUSTIN PLLC
Entity type:Organization
Organization Name:THE NEUROPSYCHOLOGICAL ASSESSMENT CLINIC OF AUSTIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LANTRIP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-270-0511
Mailing Address - Street 1:7000 N MOPAC EXPY STE 2127
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2689
Mailing Address - Country:US
Mailing Address - Phone:512-270-0511
Mailing Address - Fax:512-655-9597
Practice Address - Street 1:7000 N MOPAC EXPY STE 2127
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-2689
Practice Address - Country:US
Practice Address - Phone:512-270-0511
Practice Address - Fax:512-655-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty