Organization
PETER BROBERG, MD AND ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSON BISHOP (CREDENTIALING COORDINATOR)
(512) 447-6096
Entity
Organization
Contact information
Practice address
4207 JAMES CASEY ST STE 305, AUSTIN, TX 78745-1193
(512) 447-6096
Mailing address
4207 JAMES CASEY ST STE 305, AUSTIN, TX 78745-1193
(512) 447-6096
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080183901
—
TX
01
—
CG5346
PALMETTO RR MEDICARE
TX
Enumeration date
09/20/2006
Last updated
10/05/2012
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