MEDICARE: DR. ROBERT CARIDI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	K0665	TX

General Provider Information

NPI Number	:	1376678623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CARIDI M.D.

Provider Business Mailing Address
First Line	:	4407 BEE CAVE RD
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6405
Country	:	US
Telephone Number	:	512-732-0732
Fax Number	:

Provider Business Practice Location Address
First Line	:	4407 BEE CAVE RD
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6405
Country	:	US
Telephone Number	:	512-732-0732
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	07/08/2007

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