Healthcare Provider Details

I. General information

NPI: 1144010091
Provider Name (Legal Business Name): RAYMOND JUDE OHLER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 RED RIVER ST GME OFFICE, SECOND FLOOR
AUSTIN TX
78712
US

IV. Provider business mailing address

1501 RED RIVER ST GME OFFICE, SECOND FLOOR
AUSTIN TX
78712
US

V. Phone/Fax

Practice location:
  • Phone: 512-495-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10093806
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: