Individual
DR. CARL BRUCE GACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., ABAP
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD, N-5, AUSTIN, TX 78759-8661
(512) 278-0198
Mailing address
P.O. BOX 140633, AUSTIN, TX 78714
(512) 278-0198
(512) 278-0198
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
30591
TX
103TC0700X
Clinical Psychologist
11432
CA
103TF0200X
Forensic Psychologist
—
—
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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