MEDICARE: ALEJANDRA GONZALEZ-BADIA

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	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1700770575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA GONZALEZ-BADIA

Provider Business Mailing Address
First Line	:	4800 MANOR RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-5522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 MANOR RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-5522
Country	:	US
Telephone Number	:	512-267-7233
Fax Number	:

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

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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