Penticuff, Michael David
Penticuff, Michael David is an sole proprietor health care provider with primary practice located at 1707 Enfield Rd , Austin TX 78703-3308. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Penticuff, Michael David can be contacted via phone (512) 454-9300.Contact Information
Primary practice address
1707 Enfield Rd
Austin TX 78703-3308
Phone: (512) 454-9300
Fax: (512) 454-9370
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2-5038 | Texas |
Profile Details
| NPI number | 1720043722 |
|---|---|
| LBN Legal business name | Penticuff, Michael David |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Aug 4th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720043722 | NPPES |
| Texas | MEDICAID | 0362865-01 |
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