Provider Demographics
NPI:1336359264
Name:DEVERE, ROSS EVAN (PHD)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:EVAN
Last Name:DEVERE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 DENALI PASS
Mailing Address - Street 2:STE 4
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2079
Mailing Address - Country:US
Mailing Address - Phone:512-261-3999
Mailing Address - Fax:512-261-3991
Practice Address - Street 1:301 DENALI PASS
Practice Address - Street 2:STE 4
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2079
Practice Address - Country:US
Practice Address - Phone:512-261-3999
Practice Address - Fax:512-261-3991
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX34236103T00000X, 103G00000X
MI6301013753103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist