Healthcare Provider Details

I. General information

NPI: 1144569450
Provider Name (Legal Business Name): ROBERT DAHN MCCAULEY NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4681 COLLEGE PARK
ROUND ROCK TX
78665-1526
US

IV. Provider business mailing address

4495 WANDERING VINE TRL
ROUND ROCK TX
78665-1266
US

V. Phone/Fax

Practice location:
  • Phone: 512-671-1100
  • Fax: 512-671-1487
Mailing address:
  • Phone: 512-840-1158
  • Fax: 512-777-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number705444
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: