Individual
TESFAYE GMICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11128 LIBERTY FARMS DR, AUSTIN, TX 78754-5972
(512) 577-8743
Mailing address
11128 LIBERTY FARMS DR, AUSTIN, TX 78754-5972
(512) 577-8743
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
04/19/2022
Last updated
02/03/2023
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