Individual
JUAN NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1147 LOST CREEK BLVD, AUSTIN, TX 78746-6338
(512) 327-8000
(512) 327-8801
Mailing address
1147 LOST CREEK BLVD, AUSTIN, TX 78746-6338
(512) 327-8000
(512) 327-8801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G6356
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138793806
CSHCN
TX
05
—
138793807
—
TX
Enumeration date
08/10/2006
Last updated
02/18/2013
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