Provider Demographics
NPI:1053471805
Name:PITTS, RICHARD J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:PITTS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:DR. RICHARD J. PITTS
Mailing Address - Street 2:2801 FORTUNA DR.
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5427
Mailing Address - Country:US
Mailing Address - Phone:512-263-2850
Mailing Address - Fax:512-263-8194
Practice Address - Street 1:3355 BEE CAVE RD
Practice Address - Street 2:SUITE 610
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6775
Practice Address - Country:US
Practice Address - Phone:512-626-6511
Practice Address - Fax:512-263-2850
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184304701Medicaid
TX8J0446Medicare PIN