MEDICARE: DANIELLE ELANA ROTT 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	2084P0800X	Psychiatry Physician	T8333	TX
2	2084P0800X	Psychiatry Physician	135073	CA

General Provider Information

NPI Number	:	1720281561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE ELANA ROTT M.D.

Provider Business Mailing Address
First Line	:	100 DEAN KEETON ST.
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78712
Country	:	US
Telephone Number	:	512-471-3515
Fax Number	:	512-471-0898

Provider Business Practice Location Address
First Line	:	1515 S CAPITAL OF TEXAS HWY STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6544
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	04/06/2023

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