MEDICARE: HEMATOLOGYNOWMD PLLC

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	207RH0003X	Hematology & Oncology Physician
2	207RH0000X	Hematology (Internal Medicine) Physician

General Provider Information

NPI Number	:	1811862790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMATOLOGYNOWMD PLLC

Provider Business Mailing Address
First Line	:	2028 E BEN WHITE BLVD STE 240
Second Line	:	PMB 6471
City	:	AUSTIN
State	:	TX
Zip	:	78741-6931
Country	:	US
Telephone Number	:	512-638-8792
Fax Number	:	737-337-5484

Provider Business Practice Location Address
First Line	:	4810 SPICEWOOD SPRINGS RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7838
Country	:	US
Telephone Number	:	512-787-5057
Fax Number	:	737-337-5484

Authorized Official
Title or Position	:	OWNER
Name	:	BOONE GOODGAME
Credential	:	MD
Telephone Number	:	737-337-5484

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	04/14/2026

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Directions to “HEMATOLOGYNOWMD PLLC ” Practice Location

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