Provider Demographics
NPI:1134661317
Name:STUART AND FRAZIER, AUSTIN PSYCHOLOGISTS
Entity Type:Organization
Organization Name:STUART AND FRAZIER, AUSTIN PSYCHOLOGISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-454-5323
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE G-5
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8661
Mailing Address - Country:US
Mailing Address - Phone:512-454-5323
Mailing Address - Fax:512-346-1923
Practice Address - Street 1:603 W 18TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1166
Practice Address - Country:US
Practice Address - Phone:512-454-5323
Practice Address - Fax:512-346-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-05
Last Update Date:2016-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24397103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780694471OtherEMPLOYEE NPI
TX1881700938OtherINDIVIDUAL NPI