Healthcare Provider Details

I. General information

NPI: 1902122823
Provider Name (Legal Business Name): PADMA K. HORVIT, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 06/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 HYMEADOW DR STE 1C
AUSTIN TX
78750-1831
US

IV. Provider business mailing address

10617 ICARUS CT
AUSTIN TX
78726-1908
US

V. Phone/Fax

Practice location:
  • Phone: 512-258-2556
  • Fax: 512-258-8408
Mailing address:
  • Phone: 512-258-2556
  • Fax: 512-258-8408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberJ4218
License Number StateTX

VIII. Authorized Official

Name: DR. PADMA KROTHAPALLI HORVIT
Title or Position: OWNER
Credential: M.D.
Phone: 512-258-2556