Healthcare Provider Details

I. General information

NPI: 1104228162
Provider Name (Legal Business Name): REGINALD C BAPTISTE, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 N MO PAC EXPY SUITE 320
AUSTIN TX
78731-3027
US

IV. Provider business mailing address

7000 N MO PAC EXPY SUITE 320
AUSTIN TX
78731-3027
US

V. Phone/Fax

Practice location:
  • Phone: 512-583-0146
  • Fax: 512-583-0147
Mailing address:
  • Phone: 512-583-0146
  • Fax: 512-583-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: REGINALD C BAPTISTE
Title or Position: PRESIDENT
Credential: MD
Phone: 512-653-2268