Active NPI
Carl Bruce Gacono, PH.D., ABAP
- Psychologist
- Austin, TX
National Provider Identifier
1780904516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 30591
- Practice address
- 4131 Spicewood Springs Rd
N-5
Austin, TX 78759-8661 - Phone
- (512) 278-0198
- NPI assigned
- Jun 3, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 30591 | TX | Primary |
| Clinical Psychologist | 103TC0700X | 11432 | CA | |
| Forensic Psychologist | 103TF0200X |
Addresses
Primary practice location
4131 Spicewood Springs Rd
N-5
Austin, TX 78759-8661
Mailing address
P.O. Box 140633
Austin, TX 78714
Phone (512) 278-0198
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 |
|---|---|---|---|
| 11432 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275523200000",
"number": "1780904516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 140633",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78714",
"telephone_number": "512-278-0198",
"fax_number": "512-278-0198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPRINGS RD",
"address_2": "N-5",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598661",
"telephone_number": "512-278-0198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GACONO",
"first_name": "CARL",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "PH.D., ABAP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-03",
"last_updated": "2010-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "30591",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "11432",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.