Provider Demographics
NPI:1851424634
Name:SIMONA SCUMPIA MD PA
Entity type:Organization
Organization Name:SIMONA SCUMPIA MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCUMPIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-467-2727
Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG 3-300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5387
Mailing Address - Country:US
Mailing Address - Phone:512-467-2727
Mailing Address - Fax:512-873-7576
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG 3-300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-467-2727
Practice Address - Fax:512-873-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3521207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0018PLOtherBCBS
TX00890RMedicare PIN