Healthcare Provider Details

I. General information

NPI: 1619180916
Provider Name (Legal Business Name): SASKIA M LYTLE-VIEIRA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 11/21/2021
Certification Date: 11/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 BEE CAVES RD STE 308
WEST LAKE HILLS TX
78746-5284
US

IV. Provider business mailing address

4611 BEE CAVES RD STE 308
WEST LAKE HILLS TX
78746-5284
US

V. Phone/Fax

Practice location:
  • Phone: 512-638-2979
  • Fax: 866-466-6438
Mailing address:
  • Phone: 512-638-2979
  • Fax: 866-466-6438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number20A11857
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberS9345
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: