MEDICARE: RIVERPLACE OBGYN PA

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

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	:	1740525237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERPLACE OBGYN PA

Provider Business Mailing Address
First Line	:	6611 RIVER PLACE BLVD
Second Line	:	SUITE 202
City	:	AUSTIN
State	:	TX
Zip	:	78730-1162
Country	:	US
Telephone Number	:	512-473-8300
Fax Number	:	512-605-3800

Provider Business Practice Location Address
First Line	:	6611 RIVER PLACE BLVD
Second Line	:	SUITE 202
City	:	AUSTIN
State	:	TX
Zip	:	78730-1162
Country	:	US
Telephone Number	:	512-473-8300
Fax Number	:	512-605-3800

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN J THOPPIL
Credential	:	M.D.
Telephone Number	:	512-473-8300

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	09/02/2014

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Directions to “RIVERPLACE OBGYN PA ” Practice Location

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