Individual
DR. GEORGE H. WITHERS PH.D.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4400 MEDICAL PKWY, AUSTIN, TX 78756-3314
(512) 459-6000
Mailing address
PO BOX 302643, AUSTIN, TX 78703-0045
(512) 459-6000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
22835
TX
103TF0000X
Family Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102985203
—
TX
01
—
680013958
RR MEDICARE NUMBER
TX
Enumeration date
04/10/2007
Last updated
10/10/2012
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