Provider Demographics
NPI:1053491720
Name:CANSLER, DAVID CLAY (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CLAY
Last Name:CANSLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 MEDICAL PKWY STE 360
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1023
Mailing Address - Country:US
Mailing Address - Phone:512-451-0454
Mailing Address - Fax:512-452-3393
Practice Address - Street 1:3705 MEDICAL PKWY STE 360
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1023
Practice Address - Country:US
Practice Address - Phone:512-451-0454
Practice Address - Fax:512-452-3393
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22007103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81004POtherBCBS ID #
TXOOTN26OtherBCBS ID #
TX81004POtherBCBS ID #