FD Medical I

Primary specialty

SpecialistTaxonomy code 174400000X

License

L2246 Issued in TX

Legal business name

FD MEDICAL I

Practice address

9600 Great Hills TRL
Ste: 150W
Austin, TX 78759-6387

Phone

(512) 502-3033

Fax

(866) 776-6641

NPI assigned

Mar 5, 2008

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Dorner

Title

Director

Phone

(512) 502-3033

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1316117492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 GREAT HILLS TRL",
            "address_2": "STE: 150W",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596387",
            "telephone_number": "512-502-3033",
            "fax_number": "866-776-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 GREAT HILLS TRL",
            "address_2": "STE: 150W",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596387",
            "telephone_number": "512-502-3033",
            "fax_number": "866-776-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FD MEDICAL I",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "DORNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "512-502-3033"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "L2246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Austin, TX
• Providers in Austin, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.