Provider Demographics
NPI:1427070465
Name:PYTOWSKI, DAVID I (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:I
Last Name:PYTOWSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:4100 EVERETT
Practice Address - Street 2:#400
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6147
Practice Address - Country:US
Practice Address - Phone:512-295-1333
Practice Address - Fax:512-295-1335
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1788213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183517503Medicaid
TX183517501Medicaid
TX183517502Medicaid
TXP01022967Medicare PIN
TX183517501Medicaid
TX183517503Medicaid
TXP00383204Medicare PIN
TX8L20774Medicare PIN
TX183517502Medicaid