Provider Demographics
NPI:1437371051
Name:KUUSISTO, KARLA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:ANN
Last Name:KUUSISTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7703 NORTH LAMAR BLVD.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752
Mailing Address - Country:US
Mailing Address - Phone:512-206-4213
Mailing Address - Fax:512-206-4286
Practice Address - Street 1:7703 NORTH LAMAR BLVD.
Practice Address - Street 2:SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752
Practice Address - Country:US
Practice Address - Phone:512-206-4213
Practice Address - Fax:512-206-4286
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM81062084P0800X
NY161618-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry