MEDICARE: DR. GENOVEVA NICOLETA PRISACARU 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	207V00000X	Obstetrics & Gynecology Physician	M5449	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
2	185720302	OTHER	TX	CSHCN

General Provider Information

NPI Number	:	1740325133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENOVEVA NICOLETA PRISACARU MD

Provider Business Mailing Address
First Line	:	11564 CEDARCLIFFE DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-3523
Country	:	US
Telephone Number	:	512-442-2300
Fax Number	:	512-442-2303

Provider Business Practice Location Address
First Line	:	11615 ANGUS RD STE 108
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-4064
Country	:	US
Telephone Number	:	512-574-6041
Fax Number	:	512-442-2303

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	12/09/2020

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