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General NPI Number Information
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NPI Number | 1467427419
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Entity Type | Organization
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Legal Business Name | TEXAS DIABETES AND ENDOCRINOLOGY, P.A.
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 6500 NORTH MO PAC EXPRESSWAY BUILDING 3, SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78731
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Country | US
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Telephone | 512-458-8400
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Fax | 512-458-8593
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Provider Business Mailing Address
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Address Line | 6500 NORTH MO PAC EXPRESSWAY BUILDING 3, SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78731
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Country | US
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Telephone | 512-458-8400
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Fax | 512-458-8593
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TIFFANY REICHLE
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Credential |
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Telephone | 512-458-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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