Provider Demographics
NPI:1235252461
Name:R MICHELLE CHOUTEAU MD PA
Entity Type:Organization
Organization Name:R MICHELLE CHOUTEAU MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:R
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CHOUTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-477-9156
Mailing Address - Street 1:2911 MEDICAL ARTS ST
Mailing Address - Street 2:STE 19A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2911 MEDICAL ARTS ST
Practice Address - Street 2:STE 19A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3376
Practice Address - Country:US
Practice Address - Phone:512-477-1954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty