Organization
MSG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK N CHUTICH (ADMINISTRATIVE ASSISTANT)
(512) 615-6215
Entity
Organization
Contact information
Practice address
2200 PARK BEND DR, BLDG. 2, SUITE 300, AUSTIN, TX 78758-5387
(512) 617-6000
Mailing address
5301 RIATA PARK COURT, BLDG. D, SUITE 200, AUSTIN, TX 78727-3438
(512) 617-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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