MEDICARE: RAHEL BERHANE 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	2080P0206X	Pediatric Gastroenterology Physician	K1363	TX
2	208000000X	Pediatrics Physician	K1363	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1740246743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAHEL BERHANE MD

Provider Business Mailing Address
First Line	:	1301 BARBARA JORDAN BLVD
Second Line	:	SUITE #200
City	:	AUSTIN
State	:	TX
Zip	:	78723-3077
Country	:	US
Telephone Number	:	512-628-1898
Fax Number	:	512-600-8149

Provider Business Practice Location Address
First Line	:	7020 EASY WIND DR STE 130
Second Line	:	SUITE #400
City	:	AUSTIN
State	:	TX
Zip	:	78752-2361
Country	:	US
Telephone Number	:	512-628-1898
Fax Number	:	512-600-8149

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/05/2013

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Directions to “ RAHEL BERHANE MD” Practice Location

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