Provider Demographics
NPI:1093798944
Name:MINGEA, ROBERT M III (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:MINGEA
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:209 S CHURCH ST
Practice Address - Street 2:SUITE A
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-2713
Practice Address - Country:US
Practice Address - Phone:512-376-2183
Practice Address - Fax:512-324-3449
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2014-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH1154207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128744306Medicaid
TX8ET190OtherBCBS
TX128744308Medicaid
TX128744309Medicaid
TX8DF128OtherBCBS
TX128744307Medicaid
TX128744308Medicaid
TX329450YL9XMedicare PIN
TX128744306Medicaid
TXTXB154130Medicare PIN
TX329450YMGJMedicare PIN