Provider Demographics
NPI:1730372491
Name:FITE, KEVIN D (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:FITE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12201 RENFERT WAY
Mailing Address - Street 2:SUITE 315
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5354
Mailing Address - Country:US
Mailing Address - Phone:512-837-6000
Mailing Address - Fax:512-837-6001
Practice Address - Street 1:12201 RENFERT WAY
Practice Address - Street 2:SUITE 315
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5354
Practice Address - Country:US
Practice Address - Phone:512-837-6000
Practice Address - Fax:512-837-6001
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
TXN5053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE0171430OtherDPS
TXFF1973254OtherDEA