Organization
DAVID T. BUTLER, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID TANKSLEY BUTLER M.D. (PRESIDENT/OWNER)
(512) 258-5800
Entity
Organization
Contact information
Practice address
11940 JOLLYVILLE RD STE 115SOUTH, AUSTIN, TX 78759-2327
(512) 258-5800
(512) 258-5310
Mailing address
11940 JOLLYVILLE RD STE 115SOUTH, AUSTIN, TX 78759-2327
(512) 258-5800
(512) 258-5310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K-4866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002244W
MEDICARE GROUP NUMBER
TX
01
—
45D1020456
CLIA
TX
Enumeration date
09/25/2007
Last updated
03/23/2012
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