Basic Information
Provider Information
NPI: 1609085042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TSAI
FirstName: RITA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 RIO GRANDE ST
Address2: SUITE 340
City: AUSTIN
State: TX
PostalCode: 787011137
CountryCode: US
TelephoneNumber: 5123248960
FaxNumber:  
Practice Location
Address1: 313 E 12TH ST
Address2: SUITE 304
City: AUSTIN
State: TX
PostalCode: 787011954
CountryCode: US
TelephoneNumber: 5123248670
FaxNumber: 5123249651
Other Information
ProviderEnumerationDate: 05/22/2007
LastUpdateDate: 01/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X57.010942OHN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XN3360TXY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
20683710105TX MEDICAID


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