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
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