MEDICARE: DR. KARA BETH DIEMER DDS

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	1223G0001X	General Practice Dentistry	22658	TX

General Provider Information

NPI Number	:	1427046119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARA BETH DIEMER DDS

Provider Business Mailing Address
First Line	:	13915 N. MOPAC EXPRESSWAY
Second Line	:	SUITE 110
City	:	AUSTIN
State	:	TX
Zip	:	78728
Country	:	US
Telephone Number	:	512-218-1130
Fax Number	:	512-215-4423

Provider Business Practice Location Address
First Line	:	13915 N. MOPAC EXPRESSWAY
Second Line	:	SUITE 110
City	:	AUSTIN
State	:	TX
Zip	:	78728
Country	:	US
Telephone Number	:	512-218-1130
Fax Number	:	512-218-4423

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	01/28/2022

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