MEDICARE: DR. PADMA KROTHAPALLI HORVIT 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	J4218	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
2	0058DP	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1215949169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PADMA KROTHAPALLI HORVIT M.D.

Provider Business Mailing Address
First Line	:	12501 HYMEADOW DR
Second Line	:	BUILDING 1 SUITE C
City	:	AUSTIN
State	:	TX
Zip	:	78750-2263
Country	:	US
Telephone Number	:	512-258-2556
Fax Number	:	512-258-8408

Provider Business Practice Location Address
First Line	:	12501 HYMEADOW DR
Second Line	:	BUILDING 1 SUITE C
City	:	AUSTIN
State	:	TX
Zip	:	78750-2263
Country	:	US
Telephone Number	:	512-258-2556
Fax Number	:	512-258-8408

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	06/12/2010

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