Provider Demographics
NPI:1710465448
Name:PAZ, MICHAEL (LPC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:PAZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 MARATHON BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3720
Mailing Address - Country:US
Mailing Address - Phone:737-228-3410
Mailing Address - Fax:
Practice Address - Street 1:4112 MARATHON BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3720
Practice Address - Country:US
Practice Address - Phone:737-228-3410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75958101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional