Basic Information
| Provider Information | |||||||||
| NPI: | 1538370309 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NASON | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 W 34TH ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123467600 | ||||||||
| FaxNumber: | 5123467603 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 W 34TH ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123467600 | ||||||||
| FaxNumber: | 5123467603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 07/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | A 121444 | CA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | P6224 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 322076603 | 05 | TX | MEDICAID | 322076602 | 05 | TX | MEDICAID |