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General NPI Number Information
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NPI Number | 1407234347
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Entity Type | Individual
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Provider Name | SAVANNAH LEIGH SOMMERHALDER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 1335 E WHITESTONE BLVD STE 120
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City | CEDAR PARK
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State | TX
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Zip | 78613-7598
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Country | US
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Telephone | 512-222-5856
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Fax | 855-828-0878
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Provider Business Mailing Address
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Address Line | 5929 BALCONES DR STE 200
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City | AUSTIN
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State | TX
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Zip | 78731-4280
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Country | US
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Telephone | 512-550-1800
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Fax | 855-828-0878
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R8276
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | BP1-0053413
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | R8276
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License Number State | TX
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