Provider Demographics
NPI:1134397672
Name:KRSTIC, BILJANA (MD)
Entity type:Individual
Prefix:DR
First Name:BILJANA
Middle Name:
Last Name:KRSTIC
Suffix:
Gender:F
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:PO BOX 26726
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0726
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1301 W 38TH ST
Practice Address - Street 2:#205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1000
Practice Address - Country:US
Practice Address - Phone:512-324-1864
Practice Address - Fax:512-419-9016
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8774207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197509601Medicaid
TX197509602Medicaid
TX197509605Medicaid
TX197509606Medicaid
TXTXB154583Medicare PIN
TX197509606Medicaid
TX197509601Medicaid
TX197509605Medicaid
TX8L3882Medicare PIN
TXTXB154581Medicare PIN