MEDICARE: DR. CATHLEEN M. HAVEMANN 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	208000000X	Pediatrics Physician	L2307	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8CT037	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932102175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHLEEN M. HAVEMANN M.D.

Provider Business Mailing Address
First Line	:	4900 MUELLER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	512-324-0165
Fax Number	:	512-324-0786

Provider Business Practice Location Address
First Line	:	4900 MUELLER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	512-324-0165
Fax Number	:	512-324-0786

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/20/2013

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Directions to “ DR. CATHLEEN M. HAVEMANN M.D.” Practice Location

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