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NPI Code Detail

MEDICARE: DR. ACE H. ALSUP III M.D.

MEDICARE: DR. ACE H. ALSUP III 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
1207R00000XInternal Medicine PhysicianD9342TX

General Provider Information

NPI Number : 1265434880
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ACE H. ALSUP III M.D.
Provider Business Mailing Address
First Line : 3407 GLENVIEW AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78703-1448
Country : US
Telephone Number : 512-459-3149
Fax Number : 512-459-6974
Provider Business Practice Location Address
First Line : 3407 GLENVIEW AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78703-1448
Country : US
Telephone Number : 512-459-3149
Fax Number : 512-459-6974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 07/09/2007

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