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General NPI Number Information
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NPI Number | 1417054495
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Entity Type | Individual
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Provider Name | JONATHAN BERNARD BUTEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 1401 MEDICAL PKWY BLDG B SUITE 311
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City | CEDAR PARK
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State | TX
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Zip | 78613-7642
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Country | US
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Telephone | 512-795-2009
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Fax | 512-241-3776
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Provider Business Mailing Address
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Address Line | 1401 MEDICAL PKWY STE 311
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City | CEDAR PARK
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State | TX
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Zip | 78613-5014
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Country | US
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Telephone | 512-795-2009
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Fax | 512-241-3776
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | F3801
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License Number State | TX
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