Provider Demographics
NPI:1902122823
Name:PADMA K. HORVIT, MD, PA
Entity type:Organization
Organization Name:PADMA K. HORVIT, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PADMA
Authorized Official - Middle Name:KROTHAPALLI
Authorized Official - Last Name:HORVIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-258-2556
Mailing Address - Street 1:10617 ICARUS CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1908
Mailing Address - Country:US
Mailing Address - Phone:512-258-2556
Mailing Address - Fax:512-258-8408
Practice Address - Street 1:12501 HYMEADOW DR STE 1C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1831
Practice Address - Country:US
Practice Address - Phone:512-258-2556
Practice Address - Fax:512-258-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4218207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A6064Medicare PIN
TXG52267Medicare UPIN