1598768475 NPI number — DR. STEVEN P MARGOLIN M.D.

Table of content: DR. STEVEN P MARGOLIN M.D. (NPI 1598768475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598768475 NPI number — DR. STEVEN P MARGOLIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARGOLIN
Provider First Name:
STEVEN
Provider Middle Name:
P
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598768475
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5222 BURNET RD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78756-2433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-459-9889
Provider Business Mailing Address Fax Number:
512-459-7373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5222 BURNET RD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78756-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-459-9889
Provider Business Practice Location Address Fax Number:
512-459-7373
Provider Enumeration Date:
05/24/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  E7180 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AM8543325 . This is a "DEA NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: E7180 . This is a "LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00035618 . This is a "DPS NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".