Provider Demographics
NPI:1891980835
Name:CENTRAL TEXAS PSYCHOLOGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:CENTRAL TEXAS PSYCHOLOGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-556-0249
Mailing Address - Street 1:207 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-2804
Mailing Address - Country:US
Mailing Address - Phone:512-556-0249
Mailing Address - Fax:
Practice Address - Street 1:207 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LAMPASAS
Practice Address - State:TX
Practice Address - Zip Code:76550-2804
Practice Address - Country:US
Practice Address - Phone:512-556-0249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26860103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty