Larry Ray Birdwell DO

NPI 1063466761 - Family Medicine - 207Q00000X

NPI Details
NPI 1063466761
Gender Male
Enumeration Date 05/19/2006
Last Updated 01/11/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
2529 S 1ST ST
SOUTH AUSTIN COMMUNITY HEALTH CENTER
AUSTIN TX, 78704-5466, US
Phone (512) 972-4722
Fax (572) 972-4748
Business Location
15 WALLER ST
ATTN: FINANCE, 5TH FLOOR
AUSTIN TX, 78702-5240, US
Phone (512) 978-9000
Fax (512) 978-9001
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number F6445
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According to our database, Larry Ray Birdwell DO NPI is 1063466761, taxonomy code is 207Q00000X and license number is F6445, license state is located at Texas. Larry Ray Birdwell DO physically located at 2529 S 1st St, Austin TX, 78704-5466. NPI Number Larry Ray Birdwell DO has the Individual type.

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1063466761 NPI number is provided on an as is basis without warranty of any kind. 1063466761 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Ray Birdwell DO are for informational purposes only.