Provider Demographics
NPI:1245332451
Name:SVOBODA, CHRISTINE JUNE (PSYD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JUNE
Last Name:SVOBODA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W CENTRAL TEXAS EXPY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-6600
Mailing Address - Country:US
Mailing Address - Phone:254-680-7553
Mailing Address - Fax:888-505-9607
Practice Address - Street 1:120 W CENTEX EXPY
Practice Address - Street 2:SUITE 202
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-7406
Practice Address - Country:US
Practice Address - Phone:254-680-7553
Practice Address - Fax:888-505-9607
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22671103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032853602Medicaid
TX393445410OtherBLUE CROSS BLUE SHIELD
TX032853602Medicaid
TX1147680OtherBEACON HEALTH