Healthcare Provider Details

I. General information

NPI: 1841633310
Provider Name (Legal Business Name): STEFANI REINOLD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEFANI HAWBAKER

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13062 E HWY 290 UNIT 112
AUSTIN TX
78737-7873
US

IV. Provider business mailing address

13062 W HWY 290 STE 112
AUSTIN TX
78737-8834
US

V. Phone/Fax

Practice location:
  • Phone: 512-270-1946
  • Fax:
Mailing address:
  • Phone: 512-270-1946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberR6265
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101258669
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR6265
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: