MEDICARE: DR. SAID HASSANE SOUBRA 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	L7568	TX
2	207RP1001X	Pulmonary Disease Physician	L7568	TX
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	L7568	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548219751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAID HASSANE SOUBRA M.D.

Provider Business Mailing Address
First Line	:	6300 LA CALMA DR
Second Line	:	SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78752-3843
Country	:	US
Telephone Number	:	512-986-7765
Fax Number	:	512-986-7768

Provider Business Practice Location Address
First Line	:	1464 E WHITESTONE BLVD
Second Line	:	SUITE 601
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-9058
Country	:	US
Telephone Number	:	512-986-7765
Fax Number	:	512-986-7608

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	11/04/2013

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Directions to “ DR. SAID HASSANE SOUBRA M.D.” Practice Location

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