Provider Demographics
NPI:1780694471
Name:FRAZIER, WILLIAM RANDOLPH (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RANDOLPH
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:BUILDING G, SUITE 5
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8661
Mailing Address - Country:US
Mailing Address - Phone:512-342-8950
Mailing Address - Fax:512-346-1923
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD
Practice Address - Street 2:BUILDING G, SUITE 5
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8661
Practice Address - Country:US
Practice Address - Phone:512-342-8950
Practice Address - Fax:512-346-1923
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX24797103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86878AMedicare UPIN