Individual
DR. TOM RIMBERT ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3807 SPICEWOOD SPRINGS RD, SUITE 200, AUSTIN, TX 78759-8965
(512) 476-9195
(512) 476-2857
Mailing address
3807 SPICEWOOD SPRINGS RD, SUITE 200, AUSTIN, TX 78759-8965
(512) 476-9195
(512) 476-2857
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
L0913
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021HW
BCBS GROUP BILLING ID
TX
01
—
00486U
MEDICARE GROUP BILLING #
TX
01
—
1245417294
GROUP NPI
TX
01
—
CK3641
RR MEDICARE GROUP ID #
TX
01
—
L0913
MEDICAL LICENSE
TX
Enumeration date
06/05/2006
Last updated
02/13/2008
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