Healthcare Provider Details

I. General information

NPI: 1578906749
Provider Name (Legal Business Name): FIONA CLAIRE ESFANDIARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FIONA CLAIRE NICHOLSON MD

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 RENFERT WAY STE 100
AUSTIN TX
78758
US

IV. Provider business mailing address

12200 RENFERT WAY STE 100
AUSTIN TX
78758-5654
US

V. Phone/Fax

Practice location:
  • Phone: 512-451-8211
  • Fax: 512-450-1146
Mailing address:
  • Phone: 512-504-7655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberQ2036
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: