=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578428751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TEXAS ENDOCRINE AND REHAB PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2025
-----------------------------------------------------
Last Update Date | 12/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5900 BALCONES DR STE 8818
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78731-4257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-520-8886
-----------------------------------------------------
Fax | 601-429-2463
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5900 BALCONES DR STE 8818
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78731-4257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-520-8886
-----------------------------------------------------
Fax | 601-429-2463
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | DR. ABHIRAM JAVVAJI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 817-520-8886
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------