Provider Demographics
NPI:1346242989
Name:HOVERMAN, ISABEL VREELAND (MD)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:VREELAND
Last Name:HOVERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 GLENVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1448
Mailing Address - Country:US
Mailing Address - Phone:512-459-3149
Mailing Address - Fax:512-459-6974
Practice Address - Street 1:3407 GLENVIEW AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1448
Practice Address - Country:US
Practice Address - Phone:512-459-3149
Practice Address - Fax:512-459-6974
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0522207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23601Medicare UPIN
TX873244Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #
TX00EH90Medicare ID - Type UnspecifiedGROUP MEDICARE #