Provider Demographics
NPI:1316238413
Name:TRAUGOTT, RICHARD CARL (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CARL
Last Name:TRAUGOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-7420
Mailing Address - Country:US
Mailing Address - Phone:830-990-4191
Mailing Address - Fax:
Practice Address - Street 1:944 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-7420
Practice Address - Country:US
Practice Address - Phone:830-990-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1277208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)