Organization Active NPI

David T. Butler, M.D., P.a.

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1366638298
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K-4866 Issued in TX
Legal business name
DAVID T. BUTLER, M.D., P.A.
Practice address
11940 Jollyville Rd Ste 115South
Austin, TX 78759-2327
Phone
(512) 258-5800
Fax
(512) 258-5310
NPI assigned
Sep 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Authorized official

Name
Dr. David Tanksley Butler, M.D.
Title
President/Owner
Phone
(512) 258-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K-4866 TX Primary

Addresses

Primary practice location

11940 Jollyville Rd Ste 115South
Austin, TX 78759-2327

Mailing address

11940 Jollyville Rd Ste 115South
Austin, TX 78759-2327
Phone (512) 258-5800

Other identifiers 2

IdentifierTypeStateIssuer
002244WOtherTXMEDICARE GROUP NUMBER
45D1020456OtherTXCLIA

National Provider Directory

National Provider Directory

Locations

11940 Jollyville Rd
Ste 115S
Austin, TX 78759
Phone (512) 258-5310

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1366638298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 JOLLYVILLE RD STE 115SOUTH",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787592327",
            "telephone_number": "512-258-5800",
            "fax_number": "512-258-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 JOLLYVILLE RD STE 115SOUTH",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787592327",
            "telephone_number": "512-258-5800",
            "fax_number": "512-258-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID T. BUTLER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "TANKSLEY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "512-258-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K-4866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "002244W",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D1020456",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.