Healthcare Provider Details

I. General information

NPI: 1851692784
Provider Name (Legal Business Name): PEDRO GUSTAVO R TEIXEIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 38TH ST STE 400
AUSTIN TX
78705-1017
US

IV. Provider business mailing address

1601 TRINITY ST STOP 704
AUSTIN TX
78712-1865
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-3440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA114510
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberQ4312
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: