Organization
ST. DAVID'S CARDIOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C. REBOK (VICE PRESIDENT)
(512) 708-9700
Entity
Organization
Contact information
Practice address
1015 E 32ND ST, SUITE 508, AUSTIN, TX 78705-2707
(512) 441-1633
(512) 480-3153
Mailing address
1015 E 32ND ST, SUITE 508, AUSTIN, TX 78705-2707
(512) 441-1633
(512) 480-3153
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0079TE
BCBS PROVIDER RECORD
TX
Enumeration date
02/15/2010
Last updated
10/27/2011
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