Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 23671 | TX |
Y | 103T00000X | Psychologist | 23671 | TX |
NPI | 1013211440 |
---|---|
Provider Name | Dr. Albert Roland Cantara |
First Address | Austin, TX 78749-4008 |
Second Address | Austin, TX 78749-4008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2010 |
Last Update Date | 28/12/2010 |