Healthcare Provider Details

I. General information

NPI: 1548471386
Provider Name (Legal Business Name): HOWARD ROBERSON BAADE FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CEDAR BEND DR
AUSTIN TX
78758-5378
US

IV. Provider business mailing address

12221 N MO PAC EXPY
AUSTIN TX
78758-2401
US

V. Phone/Fax

Practice location:
  • Phone: 512-901-4031
  • Fax: 512-901-3937
Mailing address:
  • Phone: 512-901-4031
  • Fax: 512-901-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number695717
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: