Healthcare Provider Details

I. General information

NPI: 1316426414
Provider Name (Legal Business Name): STEVEN CRAIG WHITNEY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16040 PARK VALLEY DR STE 111
ROUND ROCK TX
78681-3596
US

IV. Provider business mailing address

8240 N MOPAC EXPY STE 100
AUSTIN TX
78759-8869
US

V. Phone/Fax

Practice location:
  • Phone: 512-248-2200
  • Fax: 512-248-1950
Mailing address:
  • Phone: 512-687-1970
  • Fax: 512-407-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA12139
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: