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General NPI Number Information
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NPI Number | 1790723138
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Entity Type | Individual
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Provider Name | ANTOINETTE AUSTIN-GLASS MD
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 12221 N MOPAC EXPY
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-901-6085
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 N MOPAC EXPY STE 3-210
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City | AUSTIN
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State | TX
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Zip | 78759-8859
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Country | US
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Telephone | 512-493-9237
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Fax | 512-343-2745
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01060685
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C151927
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | R1169
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License Number State | TX
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