Healthcare Provider Details

I. General information

NPI: 1760846802
Provider Name (Legal Business Name): KRISTINA TZARTZEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 TRINITY ST BLDG B
AUSTIN TX
78712-1765
US

IV. Provider business mailing address

1601 TRINITY ST BLDG B
AUSTIN TX
78712-1765
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 Code207RG0100X
TaxonomyGastroenterology Physician
License NumberT6401
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: