Provider Demographics
NPI:1639699754
Name:INTEGRITY PSYCHOLOGY OF AUSTIN PLLC
Entity type:Organization
Organization Name:INTEGRITY PSYCHOLOGY OF AUSTIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:WACHOWIAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-978-3670
Mailing Address - Street 1:1307B N CUERNAVACA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-2637
Mailing Address - Country:US
Mailing Address - Phone:305-978-3670
Mailing Address - Fax:
Practice Address - Street 1:1460 E WHITESTONE BLVD STE 260
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2284
Practice Address - Country:US
Practice Address - Phone:512-309-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35130261QM0850X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty