MEDICARE: VERTREES HEADACHE CENTER, PLLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1972138352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERTREES HEADACHE CENTER, PLLC

Provider Business Mailing Address
First Line	:	8200 N MOPAC EXPY STE 270
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8936
Country	:	US
Telephone Number	:	512-655-3737
Fax Number	:	512-298-5354

Provider Business Practice Location Address
First Line	:	4314 MEDICAL PKWY STE 201
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-3332
Country	:	US
Telephone Number	:	512-655-3737
Fax Number	:	512-298-5354

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	STEPHANIE M VERTREES
Credential	:	MD
Telephone Number	:	512-655-3737

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	03/27/2022

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