MEDICARE: DR. ROBERT M VEZZETTI 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	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	0101232523	VA
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	M5964	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	:	1821170622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M VEZZETTI MD

Provider Business Mailing Address
First Line	:	4900 MUELLER BLVD
Second Line	:	EMERGENCY DEPARTMENT
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	512-324-0150
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 MUELLER BLVD
Second Line	:	EMERGENCY DEPARTMENT
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	512-324-0150
Fax Number	:

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	01/16/2015

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Directions to “ DR. ROBERT M VEZZETTI MD” Practice Location

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