Healthcare Provider Details

I. General information

NPI: 1972558658
Provider Name (Legal Business Name): PRATIMA VIJAY KUMAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRATIMA SINGH

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 15TH ST
AUSTIN TX
78701-1930
US

IV. Provider business mailing address

601 E 15TH ST
AUSTIN TX
78701-1930
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-7000
  • Fax: 512-324-8021
Mailing address:
  • Phone: 512-324-7000
  • Fax: 512-324-8021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberK8781
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: