Provider Demographics
NPI:1467614008
Name:LONG, RASMEY (MD)
Entity Type:Individual
Prefix:DR
First Name:RASMEY
Middle Name:
Last Name:LONG
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:PO BOX 26726
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0726
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1401 MEDICAL PKWY BLDG B
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7763
Practice Address - Country:US
Practice Address - Phone:512-324-4083
Practice Address - Fax:512-324-4717
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70791207R00000X
TXP4342207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX313202904Medicaid
TX313202903Medicaid
TX313202901Medicaid
TX313202902Medicaid
TX261920YLP1Medicare PIN
TX313202901Medicaid
TX261920YKXYMedicare PIN
TX313202904Medicaid
TXP01188913Medicare PIN
TX313202903Medicaid
TX261920YLP2Medicare PIN