Provider Demographics
NPI:1184852857
Name:LANDERS, DAVID D (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:LANDERS
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:PO BOX 93066
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78709-3066
Mailing Address - Country:US
Mailing Address - Phone:512-779-6394
Mailing Address - Fax:
Practice Address - Street 1:1301 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:BLDG C, SUITE 130
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6574
Practice Address - Country:US
Practice Address - Phone:512-779-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34013103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical