Healthcare Provider Details

I. General information

NPI: 1841738036
Provider Name (Legal Business Name): MICHAEL M DI IORIO, MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 RIALTO BLVD BLDG 1 SUITE 250
AUSTIN TX
78735-8531
US

IV. Provider business mailing address

7500 RIALTO BLVD BLDG 1 SUITE 250
AUSTIN TX
78735-8531
US

V. Phone/Fax

Practice location:
  • Phone: 512-693-8344
  • Fax:
Mailing address:
  • Phone: 512-693-8344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL DI IORIO
Title or Position: MD, OWNER
Credential:
Phone: 512-693-8531