Provider Demographics
NPI:1861996233
Name:SWIGOST, ADAM (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:SWIGOST
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 1:3801 N CAPITAL OF TEXAS HWY STE J225
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1499
Mailing Address - Country:US
Mailing Address - Phone:737-371-9916
Mailing Address - Fax:737-221-5832
Practice Address - Street 1:3801 N CAPITAL OF TEXAS HWY STE J225
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-1499
Practice Address - Country:US
Practice Address - Phone:737-371-9916
Practice Address - Fax:737-221-5832
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92023207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology