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Individual

ANDREW CARL KONTAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
(512) 218-6330
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
N0902
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP1-0022657
INSTITUTIONAL PERMIT
Enumeration date
05/21/2007
Last updated
05/04/2021
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