Individual
ROY KEITH POTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15400 FOX RUN DR, AUSTIN, TX 78737-8611
(512) 626-2643
(512) 301-3836
Mailing address
15400 FOX RUN DR, AUSTIN, TX 78737-8611
(512) 626-2643
(512) 301-3836
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D 5157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D 5157
TEXAS STATE BOARD OF MEDICAL EXAMINERS
TX
Enumeration date
11/17/2010
Last updated
11/17/2010
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