Basic Information
| Provider Information | |||||||||
| NPI: | 1972823599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALDRED | ||||||||
| FirstName: | BOOTH | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12554 RIATA VISTA CIR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787276431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127955100 | ||||||||
| FaxNumber: | 5127955122 | ||||||||
| Practice Location | |||||||||
| Address1: | 12554 RIATA VISTA CIR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787276431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134414431 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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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 | 207R00000X | BP10038240 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2085D0003X | 8153422 | UT | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging | 2085N0700X | 8153422 | UT | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | 8153422 | UT | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085N0700X | R1685 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No ID Information.