MEDICARE: DANIEL STROMBERG 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	2080P0202X	Pediatric Cardiology Physician	53774	TN
2	208000000X	Pediatrics Physician	K6722	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00729263	OTHER	TX	RAILROAD MEDICARE PTAN

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831151604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL STROMBERG MD

Provider Business Mailing Address
First Line	:	4900 MUELLER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	855-324-0091
Fax Number	:	512-380-7532

Provider Business Practice Location Address
First Line	:	4900 MUELLER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	855-324-0091
Fax Number	:	512-380-7532

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	02/11/2019

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Directions to “ DANIEL STROMBERG MD” Practice Location

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