Healthcare Provider Details

I. General information

NPI: 1831151604
Provider Name (Legal Business Name): DANIEL STROMBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD
AUSTIN TX
78723-3079
US

IV. Provider business mailing address

4900 MUELLER BLVD
AUSTIN TX
78723-3079
US

V. Phone/Fax

Practice location:
  • Phone: 855-324-0091
  • Fax: 512-380-7532
Mailing address:
  • Phone: 855-324-0091
  • Fax: 512-380-7532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number53774
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK6722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: