MEDICARE: ADDY AND UNITE 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
1	2080A0000X	Pediatric Adolescent Medicine Physician	K4339	TX

General Provider Information

NPI Number	:	1700989100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDY AND UNITE MD

Provider Business Mailing Address
First Line	:	15930 S GREAT OAKS DR
Second Line	:	B
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5526
Country	:	US
Telephone Number	:	512-255-8868
Fax Number	:	512-255-8869

Provider Business Practice Location Address
First Line	:	15930 S GREAT OAKS DR
Second Line	:	BUILDING B
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5526
Country	:	US
Telephone Number	:	512-255-8868
Fax Number	:	512-255-8869

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ANSELMO UNITE
Credential	:	MD
Telephone Number	:	512-255-8868

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	08/22/2020

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Practice Location Address:

15930 S GREAT OAKS DR , BUILDING B
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Practice Location Address:

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Directions to “ADDY AND UNITE MD ” Practice Location

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