Healthcare Provider Details

I. General information

NPI: 1457739906
Provider Name (Legal Business Name): HAMIDREZA SABER M.D, M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 RED RIVER ST
AUSTIN TX
78701-1918
US

IV. Provider business mailing address

110 SAN ANTONIO ST APT 2319
AUSTIN TX
78701-0038
US

V. Phone/Fax

Practice location:
  • Phone: 857-265-5484
  • Fax:
Mailing address:
  • Phone: 857-265-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberU0652
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: