Individual
DR. MARY BETH CISHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1301 W 38TH ST, SUITE 400, AUSTIN, TX 78705-1000
(512) 324-3440
(512) 406-6513
Mailing address
1400 N IH 35, SUITE 300, AUSTIN, TX 78701-1926
(512) 324-8300
(512) 324-8301
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
K3697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126605807
—
TX
05
—
126605808
—
TX
05
—
126605809
—
TX
05
—
126605810
—
TX
01
—
8CN878
BCBS
TX
01
—
8ET182
BCBS
TX
01
—
P00816656
RAILROAD MEDICARE
TX
Enumeration date
12/07/2005
Last updated
12/12/2014
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