Individual
JASON BOOTHE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
4310 JAMES CASEY ST, BLDG 2, AUSTIN, TX 78745-1120
(512) 416-7246
(512) 416-6791
Mailing address
4310 JAMES CASEY ST, BLDG 2, AUSTIN, TX 78745-1120
(512) 416-7246
(512) 416-6791
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
32415
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1039619
BLUELINK
—
01
—
8581BH
BCBS
—
Enumeration date
05/23/2005
Last updated
07/08/2007
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