Healthcare Provider Details

I. General information

NPI: 1598717936
Provider Name (Legal Business Name): ROBERT J ZWIENER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BARBARA JORDAN BLVD STE 200
AUSTIN TX
78723-3078
US

IV. Provider business mailing address

1301 BARBARA JORDAN BLVD STE 200
AUSTIN TX
78723-3078
US

V. Phone/Fax

Practice location:
  • Phone: 512-628-1810
  • Fax: 512-628-1811
Mailing address:
  • Phone: 512-628-1810
  • Fax: 512-628-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberG5808
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: