Provider Demographics
NPI:1366440646
Name:UNITE, ANSELMO G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANSELMO
Middle Name:G
Last Name:UNITE
Suffix:
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 1:9556 INDIGO BRUSH DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-2440
Mailing Address - Country:US
Mailing Address - Phone:512-335-6958
Mailing Address - Fax:
Practice Address - Street 1:15930 S GREAT OAKS DR
Practice Address - Street 2:BUILDING B
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5526
Practice Address - Country:US
Practice Address - Phone:512-255-8868
Practice Address - Fax:512-255-8869
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-09
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
TXK4339208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics