Organization
PEDIATRIC SURGICAL SUBSPECIALISTS
Active
Organization
PEDIATRIC SURGICAL SUBSPECIALISTS
Active
Other names
Pediatric Neurosurgery Center of Central Texas
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TODD MAXSON MD (CEO)
(512) 324-8068
Entity
Organization
Contact information
Practice address
1301 BARBARA JORDAN BLVD STE 307, AUSTIN, TX 78723-3080
(512) 324-9999
(512) 324-0643
Mailing address
1301 BARBARA JORDAN BLVD STE 307, AUSTIN, TX 78723-3080
(512) 324-9999
(512) 324-0643
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y420
MEDICARE PTAN
TX
Enumeration date
08/05/2007
Last updated
06/27/2008
Update your record
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