Provider Demographics
NPI:1841558608
Name:SHARON BISCHOFSHAUSEN PHD PLLC
Entity Type:Organization
Organization Name:SHARON BISCHOFSHAUSEN PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BISCHOFSHAUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PLLC
Authorized Official - Phone:512-342-8689
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:STE. K5
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8661
Mailing Address - Country:US
Mailing Address - Phone:512-342-8689
Mailing Address - Fax:512-342-0708
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD
Practice Address - Street 2:STE. K5
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8661
Practice Address - Country:US
Practice Address - Phone:512-342-8689
Practice Address - Fax:512-342-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23594103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1146698-01Medicaid
TX00J86PMedicare PIN