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General NPI Number Information
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NPI Number | 1710046206
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Entity Type | Individual
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Provider Name | MARJORIE E VISCARDI MD
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5701 W SLAUGHTER LN BLDG C
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City | AUSTIN
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State | TX
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Zip | 78749-6528
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Country | US
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Telephone | 512-334-2509
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Fax | 512-334-2589
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Provider Business Mailing Address
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Address Line | 706 W BEN WHITE BLVD STE A
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City | AUSTIN
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State | TX
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Zip | 78704-8144
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Country | US
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Telephone | 512-334-2509
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Fax | 512-334-2589
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 54566
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J2400
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License Number State | TX
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