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NPI Code Detail

MEDICARE: MR. BRIAN B KING APRN

MEDICARE: MR. BRIAN B KING APRN
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
1363LP2300XPrimary Care Nurse Practitioner640548TX
2363LF0000XFamily Nurse Practitioner640548TX

Other Identifiers

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

General Provider Information

NPI Number : 1558695858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN B KING APRN
Provider Business Mailing Address
First Line : 4107 SPICEWOOD SPRINGS RD STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8645
Country : US
Telephone Number : 512-397-3360
Fax Number : 512-343-7107
Provider Business Practice Location Address
First Line : 4107 SPICEWOOD SPRINGS RD STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78759-8645
Country : US
Telephone Number : 512-397-3360
Fax Number : 512-343-7107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2009
Last Update Date : 01/19/2023

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Directions to “ MR. BRIAN B KING APRN” Practice Location

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