Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103TC1900X | Counseling Psychologist | 34365 | TX |
N | 103TE1100X | Exercise & Sports Psychologist | ||
N | 103TH0004X | Health Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1104130814 |
---|---|
Provider Name | Dr. Brian Louis Vasquez |
First Address | Lakeway, TX 78734 |
Second Address | Lakeway, TX 78734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2010 |
Last Update Date | 05/08/2010 |