MEDICARE: DR. GUADALUPE RICHTER PIATT 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	208000000X	Pediatrics Physician	203087	LA
2	208000000X	Pediatrics Physician	P4692	TX
3	208000000X	Pediatrics Physician	39865	TN

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	:	1952397077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUADALUPE RICHTER PIATT MD

Provider Business Mailing Address
First Line	:	12221 N MOPAC EXPRESSWAY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758
Country	:	US
Telephone Number	:	512-901-4031
Fax Number	:

Provider Business Practice Location Address
First Line	:	8210 CEDAR CV
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-4411
Country	:	US
Telephone Number	:	512-201-3438
Fax Number	:

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	04/02/2016

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