MEDICARE: DR. LAN ANH VAN-DINH 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	208000000X	Pediatrics Physician	T0374	TX

General Provider Information

NPI Number	:	1730685686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAN ANH VAN-DINH MD

Provider Business Mailing Address
First Line	:	6210 E HWY 290 STE 240
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-1144
Country	:	US
Telephone Number	:	512-483-9596
Fax Number	:	512-406-6216

Provider Business Practice Location Address
First Line	:	12779 W SH 29
Second Line	:
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642-6332
Country	:	US
Telephone Number	:	512-778-7003
Fax Number	:	512-406-7317

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

Provider Enumeration Date	:	03/31/2018
Last Update Date	:	04/22/2022

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