Active NPI
Dave Ganesha Muthali, M.D
- Internal Medicine Physician
- Austin, TX
National Provider Identifier
1588765341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G1249
- Practice address
- 2901 Montopolis Dr
Austin, TX 78741-6411 - Phone
- (512) 389-6518
- Fax
- (512) 389-6518
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G1249 | TX | Primary |
Addresses
Primary practice location
2901 Montopolis Dr
Austin, TX 78741-6411
Mailing address
2901 Montopolis Dr
Austin, TX 78741-6411
Phone (512) 389-6518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G1249 | TX | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367539200000",
"number": "1588765341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 MONTOPOLIS DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787416411",
"telephone_number": "512-389-6518",
"fax_number": "512-389-6518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 MONTOPOLIS DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787416411",
"telephone_number": "512-389-6518",
"fax_number": "512-389-6518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTHALI",
"first_name": "DAVE",
"middle_name": "GANESHA",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2013-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "G1249",
"primary": true
}
],
"identifiers": [],
"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 May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.