MEDICARE: DR. BYRON R WELCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	H0922	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013950062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BYRON R WELCH MD

Provider Business Mailing Address
First Line	:	408 W 45TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-3014
Country	:	US
Telephone Number	:	512-451-5800
Fax Number	:	512-459-1399

Provider Business Practice Location Address
First Line	:	4100 DUVAL RD
Second Line	:	BLDG 4, STE 102
City	:	AUSTIN
State	:	TX
Zip	:	78759-4277
Country	:	US
Telephone Number	:	512-832-0999
Fax Number	:	512-832-6094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	09/02/2016

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