Healthcare Provider Details

I. General information

NPI: 1093002537
Provider Name (Legal Business Name): SERENA HON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11714 WILSON PARKE AVE SUITE 150
AUSTIN TX
78726-4060
US

IV. Provider business mailing address

4515 SETON CENTER PKWY SUITE 215 CREDENTIALING
AUSTIN TX
78759-5290
US

V. Phone/Fax

Practice location:
  • Phone: 734-247-7200
  • Fax: 512-406-7368
Mailing address:
  • Phone: 512-231-5548
  • Fax: 512-406-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number248303
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: