Healthcare Provider Details

I. General information

NPI: 1366458747
Provider Name (Legal Business Name): PATRICK J. SWINT MS, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 BEE CAVE RD
WEST LAKE HILLS TX
78746-5280
US

IV. Provider business mailing address

2127 WIMBERLY LN
AUSTIN TX
78735-1493
US

V. Phone/Fax

Practice location:
  • Phone: 512-439-1175
  • Fax:
Mailing address:
  • Phone: 512-689-7965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA01830
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: