Healthcare Provider Details

I. General information

NPI: 1295894756
Provider Name (Legal Business Name): ROBIN HADDEN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W SLAUGHTER LN BLDG 6, STE 100
AUSTIN TX
78749-3997
US

IV. Provider business mailing address

5000 W SLAUGHTER LN BLDG 6, STE 100
AUSTIN TX
78749-3997
US

V. Phone/Fax

Practice location:
  • Phone: 512-282-2273
  • Fax: 512-280-1446
Mailing address:
  • Phone: 512-282-2273
  • Fax: 512-280-1446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00470
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA04497
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: