Healthcare Provider Details

I. General information

NPI: 1982878617
Provider Name (Legal Business Name): KEREM OZER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 DEEPWOOD DR SUITE 104
ROUND ROCK TX
78681-4944
US

IV. Provider business mailing address

6500 N MOPAC BLDG 3, STE 200
AUSTIN TX
78731-3282
US

V. Phone/Fax

Practice location:
  • Phone: 512-458-8400
  • Fax: 512-458-8593
Mailing address:
  • Phone: 512-458-8400
  • Fax: 512-458-8593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM8894
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberM8894
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: