Individual
JOHN D KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
720 W 34TH ST STE 100, AUSTIN, TX 78705-1205
(512) 476-3333
Mailing address
720 W 34TH ST STE 100, AUSTIN, TX 78705-1205
(512) 476-3333
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2-0506
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00MH58
BCBS
TX
Enumeration date
01/30/2007
Last updated
07/08/2007
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