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NPI Code Detail

MEDICARE: ANGELA AUGUSTINO

MEDICARE:   ANGELA  AUGUSTINO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1053942839
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA AUGUSTINO
Provider Business Mailing Address
First Line : 2008 SAN ANTONIO ST APT 104
Second Line :
City : AUSTIN
State : TX
Zip : 78705-5546
Country : US
Telephone Number : 469-321-0439
Fax Number :
Provider Business Practice Location Address
First Line : 2008 SAN ANTONIO ST APT 104
Second Line :
City : AUSTIN
State : TX
Zip : 78705-5546
Country : US
Telephone Number : 469-321-0439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2020
Last Update Date : 01/30/2020

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Directions to “ ANGELA AUGUSTINO ” Practice Location

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