Healthcare Provider Details

I. General information

NPI: 1093026734
Provider Name (Legal Business Name): JOSEPH L KUGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 MILLS AVE
AUSTIN TX
78731-6309
US

IV. Provider business mailing address

3501 MILLS AVENUE
AUSTIN TX
78731
US

V. Phone/Fax

Practice location:
  • Phone: 512-805-1810
  • Fax:
Mailing address:
  • Phone: 512-805-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberBP1-0036631
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: