Healthcare Provider Details

I. General information

NPI: 1083962450
Provider Name (Legal Business Name): CRISTIANA LAVINIA ANGELELLI I M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W WILLIAM CANNON DR STE 400
AUSTIN TX
78745-5879
US

IV. Provider business mailing address

211 E 7TH ST STE 700
AUSTIN TX
78701-3218
US

V. Phone/Fax

Practice location:
  • Phone: 888-478-8432
  • Fax: 737-707-3908
Mailing address:
  • Phone: 884-788-4328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ4557
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: