Provider Demographics
NPI:1033376454
Name:TOBIS, IRENE (PHD)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:TOBIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 E HIGHWAY 290
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1172
Mailing Address - Country:US
Mailing Address - Phone:512-327-9494
Mailing Address - Fax:512-637-5578
Practice Address - Street 1:6633 E HIGHWAY 290
Practice Address - Street 2:SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1172
Practice Address - Country:US
Practice Address - Phone:512-327-9494
Practice Address - Fax:512-637-5578
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33818103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral