Healthcare Provider Details
I. General information
NPI: 1972946150
Provider Name (Legal Business Name): ANNE HOLLAND MARDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/08/2013
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 W 38TH ST STE 205
AUSTIN TX
78705-1011
US
IV. Provider business mailing address
1301 W 38TH ST STE 705
AUSTIN TX
78705-1016
US
V. Phone/Fax
- Phone: 512-324-7036
- Fax: 512-324-7555
- Phone: 512-324-7036
- Fax: 512-324-7555
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207SG0201X |
| Taxonomy | Clinical Genetics (M.D.) Physician |
| License Number | S9741 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | S9741 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | S9741 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: