Provider Demographics
NPI:1063891687
Name:AUSTIN AND ROUND ROCK TRAVEL AND INFECTIOUS DISEASES LLC
Entity type:Organization
Organization Name:AUSTIN AND ROUND ROCK TRAVEL AND INFECTIOUS DISEASES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-324-4818
Mailing Address - Street 1:301 SETON PKWY
Mailing Address - Street 2:SUITE 402
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-8002
Mailing Address - Country:US
Mailing Address - Phone:512-324-4818
Mailing Address - Fax:
Practice Address - Street 1:301 SETON PKWY
Practice Address - Street 2:SUITE 402
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8002
Practice Address - Country:US
Practice Address - Phone:512-324-4818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty