MEDICARE: DR. ROSANNE BUTERA DC

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	111N00000X	Chiropractor	5617	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	:	1205836178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSANNE BUTERA DC

Provider Business Mailing Address
First Line	:	1803 W 35TH ST
Second Line	:	SUITE A
City	:	AUSTIN
State	:	TX
Zip	:	78703-1370
Country	:	US
Telephone Number	:	512-323-6767
Fax Number	:	512-302-0244

Provider Business Practice Location Address
First Line	:	1803 W 35TH ST
Second Line	:	SUITE A
City	:	AUSTIN
State	:	TX
Zip	:	78703-1370
Country	:	US
Telephone Number	:	512-323-6767
Fax Number	:	512-302-0244

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/27/2012

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Directions to “ DR. ROSANNE BUTERA DC” Practice Location

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