MEDICARE: ASHWIN GOWDA MD 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	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	L5347	TX
2	2080S0012X	Pediatric Sleep Medicine Physician	L5347	TX
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	L5347	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0002RB	OTHER	TX	BCBS GROUP #

General Provider Information

NPI Number	:	1992982532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHWIN GOWDA MD PA

Provider Business Mailing Address
First Line	:	1221 W BEN WHITE BLVD
Second Line	:	A-100
City	:	AUSTIN
State	:	TX
Zip	:	78704-7192
Country	:	US
Telephone Number	:	512-440-5757
Fax Number	:	512-440-5858

Provider Business Practice Location Address
First Line	:	1221 W BEN WHITE BLVD
Second Line	:	A-100
City	:	AUSTIN
State	:	TX
Zip	:	78704-7192
Country	:	US
Telephone Number	:	512-440-5757
Fax Number	:	512-440-5858

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ASHWIN GOWDA
Credential	:	MD
Telephone Number	:	512-440-5757

Provider Enumeration Date	:	01/25/2008
Last Update Date	:	09/04/2014

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Directions to “ASHWIN GOWDA MD PA ” Practice Location

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