Organization
TEXAS DIABETES AND ENDOCRINOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY REICHLE (OFFICE MANAGER)
(512) 458-8400
Entity
Organization
Contact information
Practice address
6500 NORTH MO PAC EXPRESSWAY, BUILDING 3, SUITE 200, AUSTIN, TX 78731
(512) 458-8400
(512) 458-8593
Mailing address
6500 NORTH MO PAC EXPRESSWAY, BUILDING 3, SUITE 200, AUSTIN, TX 78731
(512) 458-8400
(512) 458-8593
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
363A00000X
Physician Assistant
—
TX
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
710R
BCBS GROUP #
TX
Enumeration date
02/22/2006
Last updated
05/22/2008
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