Individual
DR. SIMON PAUL CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 PARK BEND DR BLDG 2, AUSTIN, TX 78758-5387
(512) 351-8386
Mailing address
2200 PARK BEND DR BLDG 2, AUSTIN, TX 78758-5387
(512) 351-8386
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
D0063079
MD
2085R0202X
Diagnostic Radiology Physician
Primary
M9196
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197038604
—
TX
05
—
197038606
—
TX
01
—
2849
B/C B/S
DC
05
—
409116700
—
MD
01
—
J062
B/C B/S
MD
01
—
KA80
B/C B/S
MD
Enumeration date
02/10/2006
Last updated
04/13/2011
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