Dr. Shirin M. Bazaz, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

33557 Issued in TX

Legal business name

DR. SHIRIN M. BAZAZ, LLC

Practice address

1600 W 38TH St
Suite 420
Austin, TX 78731-6400

Phone

(512) 636-1704

Fax

(512) 374-4901

NPI assigned

Sep 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shirin M Bazaz, PSY.D.NPI 1861529943

Title

President

Phone

(512) 636-1704

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shirin M Bazaz, PSY.D.

  • Clinical Psychologist
  • Cedar Park, TX
  • NPI 1861529943
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253404800000",
    "number": "1114251493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 420",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-636-1704",
            "fax_number": "512-374-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 420",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-636-1704",
            "fax_number": "512-374-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SHIRIN M. BAZAZ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-20",
        "last_updated": "2009-09-20",
        "status": "A",
        "authorized_official_last_name": "BAZAZ",
        "authorized_official_first_name": "SHIRIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-636-1704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.