Provider Demographics
NPI:1811918816
Name:HAWKINS, RAYMOND C (PHD)
Entity type:Individual
Prefix:PROF
First Name:RAYMOND
Middle Name:C
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4487
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78765-4487
Mailing Address - Country:US
Mailing Address - Phone:512-292-1122
Mailing Address - Fax:512-292-1144
Practice Address - Street 1:314 E HIGHLAND MALL BLVD
Practice Address - Street 2:STE 305
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3735
Practice Address - Country:US
Practice Address - Phone:512-292-1122
Practice Address - Fax:512-292-1144
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21620103TC0700X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86944AOtherBCBS
TX86944AOtherBCBS