Round Rock Medical Aesthetics and Urgent Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L2154 Issued in TX

Legal business name

ROUND ROCK MEDICAL AESTHETICS AND URGENT CARE PLLC

Practice address

2400 Ih 35 S
Suite 135
Round Rock, TX 78681-7912

Phone

(512) 246-2639

Fax

(512) 246-7414

NPI assigned

Mar 10, 2008

Last updated

Mar 10, 2008By 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

Lawrence David Broder, MDNPI 1467468736

Title

Owner

Phone

(512) 246-2639

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lawrence David Broder, MD

  • Family Medicine Physician
  • Austin, TX
  • NPI 1467468736
  NPD (past) Authorized official

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1598935165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 IH 35 S",
            "address_2": "SUITE 135",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786817912",
            "telephone_number": "512-246-2639",
            "fax_number": "512-246-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 IH 35 S",
            "address_2": "SUITE 135",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786817912",
            "telephone_number": "512-246-2639",
            "fax_number": "512-246-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND ROCK MEDICAL AESTHETICS AND URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "BRODER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-246-2639",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Round Rock Health & Wellness LLC
• Round Rock Healthcare & Chiropractic, PLLC
• Round Rock Imaging LLC (Akumin)
• Round Rock Independent School District
• Round Rock Manual Therapy and Pelvic Rehabilitation, PLLC
• Round Rock Mental Health PA (Central Texas Mental Health)
• Round Rock Modern Dentistry, PC (Round Rock Modern Dentistry)
• Round Rock OBGYN PA
• Round Rock Orthotics & Prosthetics, Inc. (Hanger Clinic)
• Round Rock Rehab, PC

• Family Medicine Physician in Round Rock, TX
• Providers in Round Rock, 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 Mar 10, 2008; 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.