Active NPI
Brian Louis Vasquez, PH.D.
- Counseling Psychologist
- Lakeway, TX
National Provider Identifier
1104130814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 34365
- Practice address
- 801 RR 620 South
Ste 100 F
Lakeway, TX 78734 - Phone
- (512) 981-7789
- NPI assigned
- Aug 5, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Counseling Psychologist | 103TC1900X | 34365 | TX | Primary |
| Exercise & Sports Psychologist | 103TE1100X | |||
| Health Psychologist | 103TH0004X | |||
| Group Psychotherapy Psychologist | 103TP2701X |
Addresses
Primary practice location
801 RR 620 South
Ste 100 F
Lakeway, TX 78734
Mailing address
15201 Falcon Dr.
Lakeway, TX 78734
Phone (512) 656-1231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34365 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1104130814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15201 FALCON DR.",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "78734",
"telephone_number": "512-656-1231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 RR 620 SOUTH",
"address_2": "STE 100 F",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "78734",
"telephone_number": "512-981-7789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "BRIAN",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-05",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "34365",
"primary": true
},
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.