MEDICARE: DR. SHAWN ANTHONY TASSONE 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	207V00000X	Obstetrics & Gynecology Physician	29157	AZ

General Provider Information

NPI Number	:	1518940808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN ANTHONY TASSONE M.D.

Provider Business Mailing Address
First Line	:	505 W LOUIS HENNA BLVD
Second Line	:	SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78728-1701
Country	:	US
Telephone Number	:	512-956-0296
Fax Number	:	512-777-4527

Provider Business Practice Location Address
First Line	:	505 W LOUIS HENNA BLVD
Second Line	:	SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78728-1701
Country	:	US
Telephone Number	:	512-956-0296
Fax Number	:	512-777-4527

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	04/20/2017

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