| Doctor Name: | DR. BRIAN LOUIS VASQUEZ |
| NPI Number: | 1104130814 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 801 Rr 620 South Ste 100 F Lakeway, TX - 78734 |
| Business Phone Number: | 5129817789 |
| Business Fax Number: | |
| Mailing Address: | 15201 Falcon Dr., LAKEWAY |
| State: | TX |
| Postal Code: | 78734 |
| Phone Number: | 5126561231 |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2010 |
| NPI Last Update Date: | 08/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |