MEDICARE: ROBERT HUGH OVERBAUGH M. D.

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	208VP0014X	Interventional Pain Medicine Physician	Q0331	TX

General Provider Information

NPI Number	:	1043262264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT HUGH OVERBAUGH M. D.

Provider Business Mailing Address
First Line	:	1919 ROGERS RD
Second Line	:	SUITE 104
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4614
Country	:	US
Telephone Number	:	210-541-0700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 ROGERS RD
Second Line	:	SUITE 104
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4614
Country	:	US
Telephone Number	:	210-541-0700
Fax Number	:

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/27/2016

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