Provider Demographics
NPI:1902985427
Name:BATLLE, AUGUSTIN ROGER (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTIN
Middle Name:ROGER
Last Name:BATLLE
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 1:105 BUSH CV
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-2400
Mailing Address - Country:US
Mailing Address - Phone:512-308-1555
Mailing Address - Fax:
Practice Address - Street 1:195 S. HASLER BLVD.
Practice Address - Street 2:SUITE B-1
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4081
Practice Address - Country:US
Practice Address - Phone:512-308-1555
Practice Address - Fax:512-308-1565
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF86772Medicare UPIN