MEDICARE: AMY NEUHOFF ROBERTSON 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	207W00000X	Ophthalmology Physician	K4213	TX

General Provider Information

NPI Number	:	1700955689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NEUHOFF ROBERTSON M.D.

Provider Business Mailing Address
First Line	:	13209 COUNTRY LAKE DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1901
Country	:	US
Telephone Number	:	512-266-2322
Fax Number	:	512-266-2322

Provider Business Practice Location Address
First Line	:	12171 W PARMER LN
Second Line	:	STE 201
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-7361
Country	:	US
Telephone Number	:	512-528-1144
Fax Number	:	512-528-1143

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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