Provider Demographics
NPI:1285645010
Name:AOUEILLE, BERNARD III (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:AOUEILLE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:A - 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6445
Mailing Address - Country:US
Mailing Address - Phone:512-327-9400
Mailing Address - Fax:512-329-5522
Practice Address - Street 1:1101 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:A - 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6445
Practice Address - Country:US
Practice Address - Phone:512-327-9400
Practice Address - Fax:512-329-5522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF37172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB20929Medicare UPIN