Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 34475 | TX |
N | 103TC0700X | Clinical Psychologist | 34475 | TX |
N | 103G00000X | Clinical Psychologist | 34475 | TX |
N | 103TC0700X | Clinical Psychologist | 34475 | TX |
Y | 103TP0016X | Prescribing (Medical) | MP.000041 | LA |
N | 103TR0400X | Rehabilitation Psychologist | 34475 | TX |
NPI | 1710201611 |
---|---|
Provider Name | Dr. James G Underhill |
First Address | Austin, TX 78720-4181 |
Second Address | Austin, TX 78703-4771 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2010 |
Last Update Date | 21/10/2021 |