Healthcare Provider Details

I. General information

NPI: 1285618421
Provider Name (Legal Business Name): RICARDO LONGARINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11714 WILSON PARKE AVE STE 150
AUSTIN TX
78726-4061
US

IV. Provider business mailing address

6210 E HIGHWAY 290
AUSTIN TX
78723-1142
US

V. Phone/Fax

Practice location:
  • Phone: 737-247-7200
  • Fax: 512-406-7368
Mailing address:
  • Phone: 512-483-9596
  • Fax: 512-406-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD035344E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU3283
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD035344E
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2006-01851
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: