MEDICARE: ROBERT E BUTLER 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	207Y00000X	Otolaryngology Physician	K5842	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	88691J	OTHER	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477646917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E BUTLER M.D.

Provider Business Mailing Address
First Line	:	3705 MEDICAL PKWY
Second Line	:	SUITE 320
City	:	AUSTIN
State	:	TX
Zip	:	78705-1019
Country	:	US
Telephone Number	:	512-454-0392
Fax Number	:	512-454-1233

Provider Business Practice Location Address
First Line	:	4315 JAMES CASEY ST
Second Line	:	SUITE 300
City	:	AUSTIN
State	:	TX
Zip	:	78745-3365
Country	:	US
Telephone Number	:	512-444-7944
Fax Number	:	512-444-7946

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	11/13/2012

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