Healthcare Provider Details

I. General information

NPI: 1013598135
Provider Name (Legal Business Name): AMATYA TARAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 TRINITY ST
AUSTIN TX
78712-1765
US

IV. Provider business mailing address

PO BOX 739960
DALLAS TX
75373-9960
US

V. Phone/Fax

Practice location:
  • Phone: 833-882-2737
  • Fax:
Mailing address:
  • Phone:
  • Fax: 512-495-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberW9482
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: