Provider Demographics
NPI:1548373079
Name:AUTH, MICHAEL (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:AUTH
Suffix:
Gender:M
Credentials:DO
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Other - Last Name:
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Mailing Address - Street 1:4900 MUELLER BLVD
Mailing Address - Street 2:C/O DELL CHILDREN'S MEDICAL CENTER
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3079
Mailing Address - Country:US
Mailing Address - Phone:512-324-0000
Mailing Address - Fax:512-324-0721
Practice Address - Street 1:4900 MUELLER BLVD
Practice Address - Street 2:C/O DELL CHILDREN'S MEDICAL CENTER
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-324-0000
Practice Address - Fax:512-324-0721
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM34592080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179744101Medicaid
8G8878Medicare PIN