| Central Austin Psychology Group, Pllc | |
|
3303 Northland Dr. Suite 310 Austin TX 78731-4956 | |
| (512) 495-9556 | |
| (512) 495-9774 |
| Full Name | Central Austin Psychology Group, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 3303 Northland Dr., Austin, Texas |
| Authorized Official Name and Position | Andrea M Zeddies (OWNER) |
| Authorized Official Contact | 5124959556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Austin Psychology Group, Pllc 3303 Northland Dr. Suite 310 Austin TX 78731-4956 Ph: (512) 495-9556 | Central Austin Psychology Group, Pllc 3303 Northland Dr. Suite 310 Austin TX 78731-4956 Ph: (512) 495-9556 |
| NPI Number | 1356797278 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 05/10/2016 |
| Medicare PECOS PAC ID | 1951639053 |
|---|---|
| Medicare Enrollment ID | O20190828000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356797278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (Texas) | Secondary |
| 103T00000X | Psychologist | (Texas) | Primary |
| Provider Name | Andrea M Zeddies |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285799544 PECOS PAC ID: 2062496326 Enrollment ID: I20040615000551 |
| Provider Name | Timothy J Zeddies |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649335985 PECOS PAC ID: 1951639061 Enrollment ID: I20190828001236 |
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