Dewitt Family Care Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEWITT FAMILY CARE CLINIC

Practice address

1700 RR 620 S
Suite B
Lakeway, TX 78734-6245

Phone

(512) 263-9111

Fax

(512) 263-3122

NPI assigned

Aug 17, 2007

Organization subpart

No

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

Authorized official

Name

Ronald Glenn Dewitt, M.D.

Title

Owner

Phone

(512) 263-9111

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1376735803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RR 620 S",
            "address_2": "SUITE B",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346245",
            "telephone_number": "512-263-9111",
            "fax_number": "512-263-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RR 620 S",
            "address_2": "SUITE B",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346245",
            "telephone_number": "512-263-9111",
            "fax_number": "512-263-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEWITT FAMILY CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-263-9111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00QM64",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Lorell Dearth, M.S., CCC-SLP
• Rachel Deckler, RN
• Paul Delomel, RPH
• Derwin Emil Bios
• Naresh Venkat Desireddi, MD
• Dewitt Family Care Clinic, PA
• Ronald Glenn Dewitt, M.D.
• Olivia Dexter, PA-C
• Diane Nguyen DO PLLC
• Justin Anthony De Leon Diaz, PT

• Family Medicine Physician in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.