Provider Demographics
NPI:1265988919
Name:REN PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:REN PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-588-2426
Mailing Address - Street 1:2520 LONGVIEW ST STE 410
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2520 LONGVIEW ST STE 410
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4257
Practice Address - Country:US
Practice Address - Phone:512-588-2426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty