MEDICARE: DR. MICHAEL A BUTLER 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	207V00000X	Obstetrics & Gynecology Physician	K8039	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K8039	OTHER	TX	MEDICAL BOARD LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245445832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL A BUTLER MD

Provider Business Mailing Address
First Line	:	205 E UNIVERSITY AVE
Second Line	:	SUITE 200
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-6821
Country	:	US
Telephone Number	:	512-686-0207
Fax Number	:	512-869-2940

Provider Business Practice Location Address
First Line	:	2300 ROUND ROCK AVE STE 208
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4026
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:	512-255-5307

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/21/2022

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