Healthcare Provider Details

I. General information

NPI: 1568486066
Provider Name (Legal Business Name): MICHELLE HAAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N INTERSTATE 35 STE 770
AUSTIN TX
78705-1853
US

IV. Provider business mailing address

3000 N INTERSTATE 35 STE 770
AUSTIN TX
78705-1853
US

V. Phone/Fax

Practice location:
  • Phone: 512-482-8880
  • Fax: 512-482-8862
Mailing address:
  • Phone: 512-482-8880
  • Fax: 512-482-8862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK6782
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: