Healthcare Provider Details

I. General information

NPI: 1588633846
Provider Name (Legal Business Name): ROBERT E. HOOTKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2119 WIMBERLY LN
AUSTIN TX
78735-1493
US

IV. Provider business mailing address

2119 WIMBERLY LN
AUSTIN TX
78735-1493
US

V. Phone/Fax

Practice location:
  • Phone: 512-797-4668
  • Fax: 512-330-9591
Mailing address:
  • Phone: 512-797-4668
  • Fax: 512-330-9591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberH0462
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: