Individual
JASON S REICHENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
313 EAST 12TH ST, SUITE 103 DERMATOLOGY, AUSTIN, TX 78701-0001
(512) 324-9650
(512) 324-9653
Mailing address
1601 RIO GRANDE ST, SUITE 340, AUSTIN, TX 78701-1137
(512) 324-8960
(512) 324-8962
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M4471
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182011004
—
TX
Enumeration date
01/24/2006
Last updated
01/29/2013
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