Provider Demographics
NPI:1487954293
Name:SPRAGGINS, ANDREA B (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:B
Last Name:SPRAGGINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 WESTERN TRAILS BLVD.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-448-3221
Mailing Address - Fax:512-448-3218
Practice Address - Street 1:2222 WESTERN TRAILS BLVD.
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-448-3221
Practice Address - Fax:512-448-3218
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34798103TC1900X
TX3-4798103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX216794201Medicaid