Provider Demographics
NPI:1316240799
Name:HUBER, JOHN D (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:HUBER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 FORT VW
Mailing Address - Street 2:101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7657
Mailing Address - Country:US
Mailing Address - Phone:512-541-2133
Mailing Address - Fax:
Practice Address - Street 1:1825 FORT VW
Practice Address - Street 2:101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7657
Practice Address - Country:US
Practice Address - Phone:512-541-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34416103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical