Provider Demographics
NPI:1114416807
Name:BABILA TITA, VANATIUS NKETI (DPM)
Entity Type:Individual
Prefix:
First Name:VANATIUS
Middle Name:NKETI
Last Name:BABILA TITA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:VANATIUS
Other - Middle Name:NKETI
Other - Last Name:BABILA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:5625 EIGER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8978
Mailing Address - Country:US
Mailing Address - Phone:512-447-4122
Mailing Address - Fax:512-614-4139
Practice Address - Street 1:5625 EIGER RD STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8978
Practice Address - Country:US
Practice Address - Phone:512-447-4122
Practice Address - Fax:512-614-4139
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3096213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist