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NPI Code Detail

MEDICARE: DR. SERENA EDNA SCOTT MD

MEDICARE: DR. SERENA EDNA SCOTT 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
12080N0001XNeonatal-Perinatal Medicine PhysicianL9468TX

General Provider Information

NPI Number : 1538122239
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SERENA EDNA SCOTT MD
Provider Business Mailing Address
First Line : 1201 W 38TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1006
Country : US
Telephone Number : 512-324-1085
Fax Number : 512-324-1089
Provider Business Practice Location Address
First Line : 1201 W 38TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1006
Country : US
Telephone Number : 512-324-1085
Fax Number : 512-324-1089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 07/08/2007

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